Doctor Name: | AMANDA WATTS |
NPI Number: | 1710394390 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHP, LPC |
License Number: | |
Business Practice Address: | 212 Bordeaux St Chadron, NE - 693372344 |
Business Phone Number: | 3084301944 |
Business Fax Number: | 7756676079 |
Mailing Address: | 502 Henkens Dr, CHADRON |
State: | NE |
Postal Code: | 693372450 |
Phone Number: | 3084301944 |
Fax Number: | 7756676079 |
NPI Enumeration Date: | 07/16/2014 |
NPI Last Update Date: | 06/25/2015 |
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: |