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General NPI Number Information
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NPI Number | 1124101357
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Entity Type | Individual
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Provider Name | DANA WATTS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20525 CENTER RIDGE RD STE 610
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City | ROCKY RIVER
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State | OH
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Zip | 44116-3447
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Country | US
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Telephone | 440-895-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 4637 W 224TH ST
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City | FAIRVIEW PARK
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State | OH
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Zip | 44126-2505
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Country | US
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Telephone | 440-779-2401
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 5011
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License Number State | OH
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