Jennifer Dattilo Watts, | |
2206 Executive Dr Ste A, Hampton, VA 23666-2583 | |
(757) 597-8350 | |
Not Available |
Full Name | Jennifer Dattilo Watts |
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Gender | Female |
Speciality | Marriage & Family Therapist |
Location | 2206 Executive Dr Ste A, Hampton, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124669858 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | 0717001579 (Virginia) | Primary |
Entity Name | Fly Family Therapy Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881171668 PECOS PAC ID: 7315377173 Enrollment ID: O20200417001638 |
Mailing Address | Practice Location Address |
---|---|
Jennifer Dattilo Watts, 120 Long Bridge Rd, Hampton, VA 23669-2021 Ph: (757) 813-5578 | Jennifer Dattilo Watts, 2206 Executive Dr Ste A, Hampton, VA 23666-2583 Ph: (757) 597-8350 |
Kirsten Burt, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 2202 Executive Dr Ste C, Hampton, VA 23666 Phone: 757-827-7707 Fax: 757-838-2573 | |
Mrs. Gwendolyn Rose Mbuvi, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 15 Research Dr Ste A, Hampton, VA 23666 Phone: 757-315-8039 | |
Shelby Debause, LMFT Couples Therapy Medicare: Medicare Enrolled Practice Location: 2202 Executive Dr, Suite C, Hampton, VA 23666 Phone: 757-827-7707 Fax: 757-838-2573 |