Individual
JULIE WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
877 BEACON ST, BOSTON, MA 02215
(617) 262-5845
Mailing address
877 BEACON ST, BOSTON, MA 02215
(617) 262-5845
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
104703
MA
103T00000X
Psychologist
190
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WAP02868
BLUE CROSS BLUE SHIELD
MA
Enumeration date
02/05/2007
Last updated
07/08/2007
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