Provider Demographics
NPI:1053101535
Name:WATTS, ANNETTE VERNELL (LMHP-R)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:VERNELL
Last Name:WATTS
Suffix:
Gender:F
Credentials:LMHP-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 BREMO RD STE 204
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2441
Mailing Address - Country:US
Mailing Address - Phone:804-824-6074
Mailing Address - Fax:800-233-2330
Practice Address - Street 1:9517 FAIRLAKE LN
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-5521
Practice Address - Country:US
Practice Address - Phone:804-300-1315
Practice Address - Fax:804-300-1315
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program