Individual
KATHY WATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
12226 FELCH ST, HOLLAND, MI 49424-9676
(269) 455-1110
Mailing address
31 DELAWARE CT, SOUTH HAVEN, MI 49090-1642
(269) 744-2546
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
6301007946
MI
207Q00000X
Family Medicine Physician
4704141333
MI
363LF0000X
Family Nurse Practitioner
Primary
4704141333
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500D111330
BC/BS
MI
01
—
680C946400
BC/BS
MI
Enumeration date
06/09/2006
Last updated
05/27/2026
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