Individual
MIA WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 E PACIFIC COAST HWY STE 430, LONG BEACH, CA 90804-6937
(562) 625-2935
Mailing address
4510 E PACIFIC COAST HWY STE 430, LONG BEACH, CA 90804-6937
(562) 625-2935
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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