Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Khallid Wooten

Individual provider Behavior Technician · NPI 1972313872

Khallid Wooten is a Behavior Technician in Detroit, Michigan. Practices as a sole proprietor. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

12005 Saint Marys St
Detroit, MI 48227-1103
Phone: (313) 439-5644
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1972313872
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 13, 2025
Last updated in NPPESJanuary 13, 2025
Certification dateJanuary 12, 2025
Mailing address12005 Saint Marys St, Detroit, MI 48227-1103

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