Individual
JACKIE LEE WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2727 BENS BRANCH DR APT 1402, KINGWOOD, TX 77339-3746
(832) 641-0273
Mailing address
2727 BENS BRANCH DR APT 1402, KINGWOOD, TX 77339-3746
(832) 641-0273
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209142
TX
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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