Provider Demographics
NPI:1275666372
Name:WATTS, REGINA PATRICIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:PATRICIA
Last Name:WATTS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MIDDLESEX ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02482-7021
Mailing Address - Country:US
Mailing Address - Phone:781-431-2376
Mailing Address - Fax:
Practice Address - Street 1:7 MIDDLESEX ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02482-7021
Practice Address - Country:US
Practice Address - Phone:781-431-2376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6743103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool