Individual
PHYLICIA WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
5510 REGENCY PLACE SUITE 203, WHITE PLAINS, MD 20695
(240) 419-2556
Mailing address
14640 GALLANT LN, WALDORF, MD 20601-5509
(513) 720-7447
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC10320
MD
101YP2500X
Professional Counselor
LGPC00235
DC
Other
Enumeration date
03/27/2017
Last updated
04/03/2020
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