Individual
VIVIAN E WATTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 S RECKER RD LOT 47, MESA, AZ 85206-6077
(480) 295-5600
Mailing address
303 S RECKER RD LOT 47, MESA, AZ 85206-6077
(480) 295-5600
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LMSW6921T
AZ
Other
Enumeration date
10/08/2021
Last updated
10/08/2021
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