Provider Demographics
NPI:1194032425
Name:WATT, FATIMA A (PSYD, MPA)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:A
Last Name:WATT
Suffix:
Gender:F
Credentials:PSYD, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-1912
Mailing Address - Country:US
Mailing Address - Phone:508-261-4675
Mailing Address - Fax:
Practice Address - Street 1:45 DAN RD STE 125
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2852
Practice Address - Country:US
Practice Address - Phone:508-261-4675
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9589103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent