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1790188969
KRISTY WATHEN
FORT MYERS, FL
NPI
1790188969
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2014-10-02
Last Update Date
2014-10-02
Business Address
-- KRISTY WATHEN
2516 GRAND AVE
FORT MYERS, FL 33901-5040
Phone number: 239-338-2977
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Mailing Address
-- KRISTY WATHEN
3763 EVANS AVE
FORT MYERS, FL 33901-9302
Phone number: 239-275-3222
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