Provider Demographics
NPI:1508020405
Name:WATTS, DEBBIE K (PHD)
Entity Type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:K
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 1:5053 WHITE CLAY PIT RD
Mailing Address - Street 2:
Mailing Address - City:HAINES CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33844-9769
Mailing Address - Country:US
Mailing Address - Phone:863-439-1681
Mailing Address - Fax:
Practice Address - Street 1:5053 WHITE CLAY PIT RD
Practice Address - Street 2:
Practice Address - City:HAINES CITY
Practice Address - State:FL
Practice Address - Zip Code:33844-9769
Practice Address - Country:US
Practice Address - Phone:863-439-1681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 6293101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL762679700Medicaid