MEDICARE: ROBIN WATTS MA, PSY.D., LCP

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	103TC0700X	Clinical Psychologist	PS-T000924	GA
2	103TC0700X	Clinical Psychologist	PSY.0004197	CO

General Provider Information

NPI Number	:	1750530671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN WATTS MA, PSY.D., LCP

Provider Business Mailing Address
First Line	:	150 W 9TH AVE
Second Line	:	UNIT 2207
City	:	DENVER
State	:	CO
Zip	:	80204
Country	:	US
Telephone Number	:	803-360-7803
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 W 9TH AVE
Second Line	:	UNIT 2207
City	:	DENVER
State	:	CO
Zip	:	80204
Country	:	US
Telephone Number	:	803-360-7803
Fax Number	:

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

Provider Enumeration Date	:	09/16/2008
Last Update Date	:	02/18/2015

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