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NPI Code Detail

MEDICARE: DAPHNE L WATTS CTRS

MEDICARE: DAPHNE L WATTS CTRS
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 Counselor18540SC

General Provider Information

NPI Number : 1518058452
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAPHNE L WATTS CTRS
Provider Business Mailing Address
First Line : 224 MEREDITH SQ
Second Line :
City : COLUMBIA
State : SC
Zip : 29223-2267
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1850 PINEVIEW DR
Second Line :
City : COLUMBIA
State : SC
Zip : 29209-5085
Country : US
Telephone Number : 803-783-0303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 07/08/2007

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Directions to “ DAPHNE L WATTS CTRS” Practice Location

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