Individual
MS. LAURIE WATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3856
Mailing address
404 E ELM AVE, MONROE, MI 48162-2657
(734) 240-0689
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
50001765
OH
363AS0400X
Surgical Physician Assistant
Primary
5601003719
MI
Other
Enumeration date
07/13/2005
Last updated
09/11/2025
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