Provider Demographics
NPI:1518517531
Name:WATT, ANTHONY PATRICK (BCBA)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:PATRICK
Last Name:WATT
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 BARBARA LN
Mailing Address - Street 2:
Mailing Address - City:FEEDING HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:01030-1042
Mailing Address - Country:US
Mailing Address - Phone:413-896-5580
Mailing Address - Fax:
Practice Address - Street 1:54 BARBARA LN
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-1042
Practice Address - Country:US
Practice Address - Phone:413-896-5580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-33874103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst