Individual
MRS. TINA M WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
14844 W 107TH ST, LENEXA, KS 66215-4002
(720) 319-7614
Mailing address
11001 NW LEMA DR APT B, PARKVILLE, MO 64152-3931
(417) 850-1309
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-33977
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
12/15/2015
Last updated
10/06/2021
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