Individual
JENNIFER DIANE WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5269
(757) 461-4826
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5269
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006294
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010252717
—
VA
Enumeration date
07/03/2006
Last updated
02/28/2020
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