Most Relevant Information
Provider Data
| NPI Number: | 1003382979 |
| Provider Name: | SARAN CHARISSE WATTS |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/18/2018 |
| Last Updated: | 09/18/2019 |
Provider Practice Location
31101 ALLEN RD
BUILDING 5
SOUTHGATE
MI
48195
Practice Location Phone/Fax
| Phone: | 6168186639 |
| Fax: |
Provider Mailing Location
31160 WILDWOOD ST APT 5210
WIXOM
MI
483932628
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |