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Individual

MRS. ANDREA LASHUN WATTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C5643

Contact information

Practice address
1911 MISSION 66 STE B, VICKSBURG, MS 39180-3762
(601) 665-4162
(855) 830-3484
Mailing address
557 GRANT FERRY RD, BRANDON, MS 39047
(601) 665-4162
(855) 830-3484

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
M5643
MS
1041C0700X
Clinical Social Worker
Primary
C5643
MS

Other

Enumeration date
09/22/2006
Last updated
10/14/2022
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