Provider Demographics
NPI:1912039470
Name:WATLER, AUBERNETTE (MSW)
Entity Type:Individual
Prefix:MS
First Name:AUBERNETTE
Middle Name:
Last Name:WATLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 SW GWENDOLEN TER
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-1524
Mailing Address - Country:US
Mailing Address - Phone:772-971-7088
Mailing Address - Fax:
Practice Address - Street 1:985 SW GWENDOLEN TER
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-1524
Practice Address - Country:US
Practice Address - Phone:772-971-7088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker