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Individual

PAUL BRADLEY WATTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC, CSOTP

Contact information

Practice address
162D MARKET PLACE BLVD, KNOXVILLE, TN 37922-2337
(865) 212-6600
(865) 313-2149
Mailing address
PO BOX 31569, KNOXVILLE, TN 37930-1569
(865) 212-6600
(865) 313-2149

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701008229
VA
101YP2500X
Professional Counselor
Primary
5913
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0701008229
VA
Enumeration date
03/18/2019
Last updated
05/02/2023
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