Most Relevant Information
Provider Data
| NPI Number: | 1003403965 |
| Provider Name: | HEATHER ANN WATERSON |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/28/2020 |
| Last Updated: | 12/28/2020 |
Provider Practice Location
634 N MAIN ST STE 4
O FALLON
IL
622693746
Practice Location Phone/Fax
| Phone: | 6187260701 |
| Fax: |
Provider Mailing Location
21600 OXNARD ST STE 1800
WOODLAND HILLS
CA
913677807
Provider Mailing Phone/Fax
| Phone: | 8183452345 |
| Fax: |