Individual
MRS. JENNIFER L WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
N27W5707 LINCOLN BLVD, CEDARBURG, WI 53012-2852
(262) 376-7676
Mailing address
N69W6171 BRIDGE RD, CEDARBURG, WI 53012-2056
(262) 388-1342
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4147-026
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41039100
—
WI
Enumeration date
05/18/2007
Last updated
07/08/2007
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