Individual
SHIELA WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12022 GREENLEAF RD, BRAGGS, OK 74423-5136
(918) 471-5485
Mailing address
PO BOX 194, BRAGGS, OK 74423-0194
(918) 471-5485
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/10/2023
Last updated
08/10/2023
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