Individual
JENNIFER DATTILO WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2206 EXECUTIVE DR STE A, HAMPTON, VA 23666-2583
(757) 597-8350
Mailing address
120 LONG BRIDGE RD, HAMPTON, VA 23669-2021
(757) 813-5578
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0717001579
VA
Other
Enumeration date
10/03/2019
Last updated
10/03/2019
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