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NPI Code Detail

MEDICARE: TRISHA WATZ

MEDICARE: TRISHA WATZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOK

General Provider Information

NPI Number : 1104383306
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRISHA WATZ
Provider Business Mailing Address
First Line : 1107 THISTLEWOOD DR
Second Line :
City : NORMAN
State : OK
Zip : 73072-3946
Country : US
Telephone Number : 405-887-0177
Fax Number :
Provider Business Practice Location Address
First Line : 425 S FRETZ AVE STE C
Second Line :
City : EDMOND
State : OK
Zip : 73003-5568
Country : US
Telephone Number : 405-726-9808
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2019
Last Update Date : 02/23/2019

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Directions to “ TRISHA WATZ ” Practice Location

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