Provider Demographics
NPI:1194106336
Name:WATTS, MAUREEN (RD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DUKE ST
Mailing Address - Street 2:SUITE 203-A
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-1511
Mailing Address - Country:US
Mailing Address - Phone:540-825-6973
Mailing Address - Fax:
Practice Address - Street 1:101 DUKE ST
Practice Address - Street 2:SUITE 203-A
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-1511
Practice Address - Country:US
Practice Address - Phone:540-825-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered