Individual
KEAHNNA MAE WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1020 WABASH ST UNIT 10-102, FORT COLLINS, CO 80526-6811
(913) 302-1990
Mailing address
1020 WABASH ST UNIT 10-102, FORT COLLINS, CO 80526-6811
(913) 302-1990
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-68223
CO
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
07/17/2018
Last updated
09/14/2023
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