Individual
JULIE WATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
42669 GARFIELD RD, CLINTON TWP, MI 48038-5036
(586) 412-5321
Mailing address
6549 TOWN CENTER DR, CLARKSTON, MI 48346-4824
(248) 620-6400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401013087
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
750910402
BLUE CROSS
MI
Enumeration date
06/20/2012
Last updated
09/21/2015
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