Individual
ANTHONY D WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
938 ELMA G MILES PKWY, HINESVILLE, GA 31313-4515
(912) 294-4055
(866) 467-4321
Mailing address
938 ELMA G MILES PKWY, HINESVILLE, GA 31313-4515
(912) 294-4055
(866) 467-4321
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-20-132169
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-20-132169
RBT NUMBER
GA
Enumeration date
08/21/2020
Last updated
08/21/2020
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