Individual
NICOLE WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
855 LAKEWOOD RD, WATERBURY, CT 06704-5408
(888) 793-3500
Mailing address
1461 MERIDEN AVE, SOUTHINGTON, CT 06489-4220
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
7442
CT
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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