Individual
IRIS TERESA WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1481
Mailing address
8809 WAVE CIR APT A, FORT WAYNE, IN 46825-3099
(260) 426-5431
(260) 460-1481
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33004039A
IN
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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