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Individual

AEVON JENENE WATTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
10311 NW 58TH ST, DORAL, FL 33178-2819
(305) 597-4545
Mailing address
9713 N NEW RIVER CANAL RD, PLANTATION, FL 33324-3423
(516) 376-7550

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
07/10/2020
Last updated
07/10/2020
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