Individual
MS. CHARLOTTE J WATTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 BEVER GRADE, LAPWAI, ID 83540
(208) 843-2271
(208) 843-7394
Mailing address
111 BEVER GRADE, LAPWAI, ID 83540
(208) 843-2271
(208) 843-7394
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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