Individual
MRS. RITA P WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
906 JUAN PEREA RD, LOS LUNAS, NM 87031-7778
(505) 866-7632
Mailing address
29 CIELO MONTANA, ALAMOGORDO, NM 88310-9547
(505) 463-6518
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0001004
CO
235Z00000X
Speech-Language Pathologist
118992
TX
235Z00000X
Speech-Language Pathologist
2026
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
R8011
—
NM
Enumeration date
01/19/2007
Last updated
05/08/2024
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