Individual
LELISA WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20600 N 260TH LN, BUCKEYE, AZ 85396-7275
(773) 351-5520
Mailing address
PO BOX 16906, PHOENIX, AZ 85011-6906
(602) 279-1427
(602) 279-1431
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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