Doctor Name: | TAMMY LEA WATTS |
NPI Number: | 1164741021 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | |
Business Practice Address: | 205 Dewey Ave Ste 2 Poteau, OK - 749534224 |
Business Phone Number: | 9186490909 |
Business Fax Number: | |
Mailing Address: | 21466 Knot Hole Rd, CAMERON |
State: | OK |
Postal Code: | 749322427 |
Phone Number: | 9187215422 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2010 |
NPI Last Update Date: | 01/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |