Provider Demographics
NPI:1174956882
Name:WATTS, KRISTIE LEIGH (LMFT)
Entity type:Individual
Prefix:
First Name:KRISTIE
Middle Name:LEIGH
Last Name:WATTS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 WESTMINSTER DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-4243
Mailing Address - Country:US
Mailing Address - Phone:317-435-7651
Mailing Address - Fax:
Practice Address - Street 1:7425 E 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1207
Practice Address - Country:US
Practice Address - Phone:317-474-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001808A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist