Individual
RAYMOND WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMHT
Contact information
Practice address
103 S 19TH AVE, HATTIESBURG, MS 39401-6171
(601) 544-4641
Mailing address
PO BOX 18679, HATTIESBURG, MS 39404-8679
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3382
MS
Other
Enumeration date
08/25/2017
Last updated
08/25/2017
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