Individual
MARY KATHLEEN WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
150 MUIR RD, MARTINEZ, CA 94553-4668
(916) 216-5457
Mailing address
125 LOOK OUT POINT CT, ROSEVILLE, CA 95747-7127
(916) 517-8230
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
32888
CA
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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