Doctor Name: | MRS. VICKI J WATT |
NPI Number: | 1982909651 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | Hc 67 Box 5 Canadian, OK - 744259700 |
Business Phone Number: | 9183395800 |
Business Fax Number: | 9183385820 |
Mailing Address: | Rr 5 Box 152, EUFAULA |
State: | OK |
Postal Code: | 744329504 |
Phone Number: | 9183395800 |
Fax Number: | 9183395820 |
NPI Enumeration Date: | 01/11/2011 |
NPI Last Update Date: | 01/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |