Individual
KAITASHA D. WOOTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1233 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-6399
(404) 905-6046
Mailing address
1247 JOSEPH E BOONE BLVD NW APT 22, ATLANTA, GA 30314-2360
(470) 905-6046
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1146
GA
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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