Individual
JACOB J WOOTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(443) 783-1773
Mailing address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(443) 783-1773
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
CER-195162-M4P1Q7
MD
Other
Enumeration date
10/24/2011
Last updated
01/07/2026
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