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NPI Code Detail

MEDICARE: TONYA WATTS LPCC-S

MEDICARE:   TONYA  WATTS  LPCC-S
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 CounselorE.0500656-SUPVOH

General Provider Information

NPI Number : 1235307927
Entity Type Code : Individual
Provider Name (Legal Business Name) : TONYA WATTS LPCC-S
Provider Business Mailing Address
First Line : 1435 MARKET AVE N
Second Line :
City : CANTON
State : OH
Zip : 44714-2609
Country : US
Telephone Number : 330-861-2444
Fax Number : 330-453-7216
Provider Business Practice Location Address
First Line : 1435 MARKET AVE N
Second Line :
City : CANTON
State : OH
Zip : 44714-2609
Country : US
Telephone Number : 330-861-2444
Fax Number : 330-453-7216
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2008
Last Update Date : 09/14/2012

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Directions to “ TONYA WATTS LPCC-S” Practice Location

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