Individual
LAVENA LOVETTE WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24757 E 869 RD, WELLING, OK 74471
(405) 778-0553
Mailing address
24757 E 869 RD, WELLING, OK 74471
(405) 778-0553
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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