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General NPI Number Information
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NPI Number | 1144708009
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Entity Type | Individual
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Provider Name | MARIA WATTERS PHD, CRC, LCMHC, LPC
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Gender | Female
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Dates
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Enumeration Date | 08/02/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 4660 NE BELKNAP CT STE 119
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City | HILLSBORO
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State | OR
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Zip | 97124-8402
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Country | US
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Telephone | 801-885-7371
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Fax |
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Provider Business Mailing Address
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Address Line | 6796 NE BIRCH ST
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City | HILLSBORO
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State | OR
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Zip | 97124-6509
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Country | US
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Telephone | 801-885-7371
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C4950
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C4950
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8935496-6004-2018091
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 225C00000X
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Taxonomy Name | Rehabilitation Counselor
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License Number | 00116673
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License Number State |
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