Healthcare Provider Details

I. General information

NPI: 1447169206
Provider Name (Legal Business Name): ALANTE WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2026
Last Update Date: 09/05/2026
Certification Date: 09/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 W BAGLEY RD
BEREA OH
44017-1370
US

IV. Provider business mailing address

245 LENELL LOOP
DELAWARE OH
43015-4364
US

V. Phone/Fax

Practice location:
  • Phone: 844-622-5564
  • Fax:
Mailing address:
  • Phone: 810-449-5632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: