Provider Demographics
NPI:1114312626
Name:WATT, CYNTHIA (MAT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:WATT
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5593 HIGHWAY 311
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2866
Mailing Address - Country:US
Mailing Address - Phone:985-868-2620
Mailing Address - Fax:985-868-8547
Practice Address - Street 1:8326 MAIN ST UNIT 3
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363-4871
Practice Address - Country:US
Practice Address - Phone:985-868-2620
Practice Address - Fax:985-868-8547
Is Sole Proprietor?:No
Enumeration Date:2015-04-01
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist