NPI Profile for MARY ROSE WATTIER in RANDOLPH, NE.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Emergency Medical Technician, Basic |
146N00000X | |||
Professional |
101YP2500X |
| NPI Number | 1952688962 |
|
| Status | Active | |
| Credentials | LMHP | |
| Entity | Individual | |
| Enumeration date | 11/05/2011 | |
| Last updated | 11/05/2011 - About 15 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MARY ROSE WATTIER
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