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General NPI Number Information
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NPI Number | 1720401813
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Entity Type | Individual
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Provider Name | ANITA TWINER-WATKINS LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 110 HAWTHORNE DR
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City | LONG BEACH
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State | MS
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Zip | 39560-8201
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Country | US
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Telephone | 601-255-7937
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Fax |
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Provider Business Mailing Address
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Address Line | 719 24TH ST
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City | GULFPORT
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State | MS
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Zip | 39501-3408
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Country | US
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Telephone | 601-255-7937
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C8040
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License Number State | MS
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