Individual
KATIE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2632 SW PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34953-2845
(772) 773-0667
Mailing address
1742 SE RIDGEWOOD ST, PORT ST LUCIE, FL 34952-6552
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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