Doctor Name: | LATONYA WATTERS |
NPI Number: | 1730405507 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 004681 |
Business Practice Address: | 20 Greenvalley Rd Se Silver Creek, GA - 301732772 |
Business Phone Number: | 4045832439 |
Business Fax Number: | |
Mailing Address: | 20 Greenvalley Rd Se, SILVER CREEK |
State: | GA |
Postal Code: | 301732772 |
Phone Number: | 4045832439 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2010 |
NPI Last Update Date: | 04/19/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 004681 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |