Basic Information
| Provider Information | |||||||||
| NPI: | 1275958167 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WATTS | ||||||||
| FirstName: | MELITA | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5140 SHOWDOWN LN | ||||||||
| Address2: | |||||||||
| City: | GRAND PRAIRIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750522449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722634338 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1126 W PIONEER PKWY | ||||||||
| Address2: | SUITE 1126 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760136367 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177951291 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2014 | ||||||||
| LastUpdateDate: | 02/28/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 15646 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.