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NPI Code Detail

MEDICARE: MRS. COURTNEY HEATHER WATT

MEDICARE: MRS. COURTNEY HEATHER WATT
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1720337025
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. COURTNEY HEATHER WATT
Provider Business Mailing Address
First Line : 10 LEDGEWOOD WAY
Second Line : UNIT 5
City : PEABODY
State : MA
Zip : 01960-1348
Country : US
Telephone Number : 978-407-9395
Fax Number :
Provider Business Practice Location Address
First Line : 132 ROBBS HILL RD
Second Line :
City : LUNENBURG
State : MA
Zip : 01462-2167
Country : US
Telephone Number : 508-302-9601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2012
Last Update Date : 07/31/2019

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Directions to “ MRS. COURTNEY HEATHER WATT ” Practice Location

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