Provider Demographics
NPI:1801463260
Name:WATTS, KIARRA L (MS, LMFT-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KIARRA
Middle Name:L
Last Name:WATTS
Suffix:
Gender:F
Credentials:MS, LMFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 COLORADO BLVD APT 516
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-6824
Mailing Address - Country:US
Mailing Address - Phone:850-341-9670
Mailing Address - Fax:
Practice Address - Street 1:2700 COLORADO BLVD APT 516
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-6824
Practice Address - Country:US
Practice Address - Phone:850-341-9670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20344106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist