Individual
MRS. BRENDA MICHELLE WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2445 NW 156TH ST, MIAMI GARDENS, FL 33054-6915
(305) 621-2226
Mailing address
2445 NW 156TH ST, MIAMI GARDENS, FL 33054-6915
(305) 621-2226
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
03/16/2009
Last updated
02/02/2019
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