Provider Demographics
NPI:1700017704
Name:WATTS, MICHAELA PRICE (MS)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:PRICE
Last Name:WATTS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MICHAELA
Other - Middle Name:MARY
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:210 TIMBER COURT DR APT B
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-8835
Mailing Address - Country:US
Mailing Address - Phone:931-206-6408
Mailing Address - Fax:
Practice Address - Street 1:201 UFFELMAN DR STE F
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-2970
Practice Address - Country:US
Practice Address - Phone:931-920-7330
Practice Address - Fax:931-920-7331
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor