Individual
JEROME A. WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
2314 KELLY PL, LORAIN, OH 44052-4838
(440) 246-4616
(440) 246-1997
Mailing address
2314 KELLY PL, LORAIN, OH 44052-4838
(440) 246-4616
(440) 246-4616
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
RA162262
OH
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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