Provider Demographics
NPI:1053130435
Name:WATTERSON, BRIA DAWN
Entity type:Individual
Prefix:
First Name:BRIA
Middle Name:DAWN
Last Name:WATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 N JEFFERSON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-1578
Mailing Address - Country:US
Mailing Address - Phone:724-300-3037
Mailing Address - Fax:724-571-4899
Practice Address - Street 1:144 N JEFFERSON ST APT 1
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-1578
Practice Address - Country:US
Practice Address - Phone:724-300-3037
Practice Address - Fax:724-571-4899
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach