Individual
CASEY WOOTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2005 RIVER ST, SUSANVILLE, CA 96130-4524
(530) 257-5341
Mailing address
526 E TAYLOR ST, RENO, NV 89502-2538
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
26742
CA
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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