Provider Demographics
NPI:1053772251
Name:WATTS, MONICA (CBGT,)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:CBGT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 COURTNEY LAKES CIR APT 106
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-2361
Mailing Address - Country:US
Mailing Address - Phone:561-629-0145
Mailing Address - Fax:
Practice Address - Street 1:310 E GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-6098
Practice Address - Country:US
Practice Address - Phone:561-629-0145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)