Individual
JULIA WOOTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
138 N COURT ST, WAMPSVILLE, NY 13163-0605
(315) 366-2841
Mailing address
138 NORTH COURT STREET, WAMPSVILLE, NY 13163-0605
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750406161
—
NY
Enumeration date
03/19/2019
Last updated
06/11/2019
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