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1194001032
JACOB J WOOTTEN
ELLICOTT CITY, MD
NPI
1194001032
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TS0200X Psychologist, School
(Licence: MD CER-195162-M4P1Q7)
Enumeration Date
2011-10-24
Last Update Date
2025-09-22
Business Address
JACOB J WOOTTEN BA
10910 CLARKSVILLE PIKE
ELLICOTT CITY, MD 21042-6106
Phone number: 443-783-1773
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Mailing Address
JACOB J WOOTTEN BA
10910 CLARKSVILLE PIKE
ELLICOTT CITY, MD 21042-6106
Phone number: 443-783-1773
Copy
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