Individual
FAYE ANN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1020 LENAPE, NOWATA, OK 74048
(918) 273-0192
(918) 273-2147
Mailing address
1020 LENAPE, NOWATA, OK 74048
(918) 273-7545
(918) 273-2147
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD987
OK
Other
Enumeration date
10/06/2005
Last updated
04/17/2008
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