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General NPI Number Information
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NPI Number | 1750425435
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Entity Type | Individual
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Provider Name | RICHARD O WATKINS II MSW LMSW
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 08/30/2007
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Provider Practice Location Address
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Address Line | 8361 ELLIS RD
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City | MILLINGTON
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State | MI
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Zip | 48746-0359
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Country | US
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Telephone | 989-871-6695
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Fax |
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Provider Business Mailing Address
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Address Line | 3462 MILLINGTON RD
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City | MILLINGTON
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State | MI
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Zip | 48746-9608
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Country | US
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Telephone | 989-239-5850
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6801071148
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6801071148
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License Number State | MI
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