Individual
CHANA WATTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1312 JACKSON AVE, TAHLEQUAH, OK 74464-6624
(405) 818-1003
Mailing address
1312 JACKSON AVE, TAHLEQUAH, OK 74464-6624
(405) 818-1003
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/26/2016
Last updated
07/26/2016
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