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General NPI Number Information
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NPI Number | 1740685312
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Entity Type | Individual
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Provider Name | LINDA TINA WATTS LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/25/2014
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Last Update Date | 10/25/2014
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Provider Practice Location Address
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Address Line | 96 5TH AVE APT 1K
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City | NEW YORK
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State | NY
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Zip | 10011-7604
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Country | US
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Telephone | 347-256-6242
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Fax | 973-403-9958
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Provider Business Mailing Address
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Address Line | 14 TEMPESTA TER
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City | WEST CALDWELL
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State | NJ
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Zip | 07006-6934
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Country | US
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Telephone | 347-256-6242
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Fax | 973-403-9958
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 054971-1
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License Number State | NY
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