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General NPI Number Information
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NPI Number | 1649861329
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Entity Type | Individual
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Provider Name | ZADA K WOOTEN MOT
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Gender | Female
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Dates
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Enumeration Date | 01/27/2021
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 602 E MAIN ST STE C4
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City | LEXINGTON
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State | SC
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Zip | 29072-3729
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Country | US
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Telephone | 803-881-4787
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Fax | 803-369-8739
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Provider Business Mailing Address
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Address Line | 128 HUXLEY CT
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City | LEXINGTON
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State | SC
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Zip | 29072-8263
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5363
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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