Provider Demographics
NPI:1871362814
Name:WATSON, BRITTANY (CCMA-CHC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:WATSON
Suffix:
Gender:F
Credentials:CCMA-CHC
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:C
Other - Last Name:DARNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCMA-CHC
Mailing Address - Street 1:864 POSSUM TROT RD
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-7820
Mailing Address - Country:US
Mailing Address - Phone:501-520-8974
Mailing Address - Fax:
Practice Address - Street 1:864 POSSUM TROT RD
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-7820
Practice Address - Country:US
Practice Address - Phone:501-520-8974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARHCF4G5M4E9171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach