MEDICARE: NORMA WATKINS

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
1	101YP2500X	Professional Counselor	995	FL

General Provider Information

NPI Number	:	1508283516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORMA WATKINS

Provider Business Mailing Address
First Line	:	3280 N STATE ROAD 7
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5615
Country	:	US
Telephone Number	:	754-246-6931
Fax Number	:	954-400-7394

Provider Business Practice Location Address
First Line	:	3280 N STATE ROAD 7
Second Line	:	SUITE A
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33319-5615
Country	:	US
Telephone Number	:	754-246-6931
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2014
Last Update Date	:	03/27/2014

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