MEDICARE: MS. DEBBIE K WATTS PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH 6293	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508020405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBBIE K WATTS PH.D.

Provider Business Mailing Address
First Line	:	5053 WHITE CLAY PIT RD
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-9769
Country	:	US
Telephone Number	:	863-439-1681
Fax Number	:

Provider Business Practice Location Address
First Line	:	5053 WHITE CLAY PIT RD
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-9769
Country	:	US
Telephone Number	:	863-439-1681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	05/09/2012

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