Provider Demographics
NPI:1538302880
Name:WATTS, NAOMI DIANE (BA, MS)
Entity type:Individual
Prefix:MRS
First Name:NAOMI
Middle Name:DIANE
Last Name:WATTS
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 E 86TH ST N
Mailing Address - Street 2:
Mailing Address - City:SPERRY
Mailing Address - State:OK
Mailing Address - Zip Code:74073-4709
Mailing Address - Country:US
Mailing Address - Phone:918-698-2637
Mailing Address - Fax:
Practice Address - Street 1:4103 S YALE AVE STE B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6002
Practice Address - Country:US
Practice Address - Phone:918-382-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK06291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health