Provider Demographics
NPI:1285458489
Name:WATTS, TABITHA M (QBHP)
Entity type:Individual
Prefix:
First Name:TABITHA
Middle Name:M
Last Name:WATTS
Suffix:
Gender:F
Credentials:QBHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 MOUNTAIN MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-9368
Mailing Address - Country:US
Mailing Address - Phone:501-655-4265
Mailing Address - Fax:
Practice Address - Street 1:339 CHARTEROAK ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6100
Practice Address - Country:US
Practice Address - Phone:501-623-5591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker