Individual provider · NPI-1

Dr. Adelle Alexandria Maynard - Watts, D.O.

Psychiatry & Neurology, Neurology · Terre Haute, IN

NPI number1881949576
StatusActive
Last updated in NPPESOct 11, 2016

Details

NPI
1881949576
Entity type
Individual (NPI-1)
Name
Dr. Adelle Alexandria Maynard - Watts
Credential
D.O.
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 18, 2012
Last updated
Oct 11, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084N0400X Psychiatry & Neurology, Neurology02004787AINYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

1739 N 4th St
Terre Haute, IN 47804-4002

Phone 812-242-1000

Mailing address

1301 Clover Ct
Terre Haute, IN 47802-9042

Phone 812-201-5561

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