Provider Demographics
NPI:1407555774
Name:WATTERS, DANIELLE M (MS, ACSM-CEP)
Entity Type:Individual
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First Name:DANIELLE
Middle Name:M
Last Name:WATTERS
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Gender:F
Credentials:MS, ACSM-CEP
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Mailing Address - Street 1:393 LINWOOD CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06415-1149
Mailing Address - Country:US
Mailing Address - Phone:860-301-2288
Mailing Address - Fax:
Practice Address - Street 1:31 UNION ST
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3126
Practice Address - Country:US
Practice Address - Phone:860-872-5157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Y00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersClinical Exercise Physiologist