Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominque Latreace Wathan, CMII, BHWC

Individual provider Peer Specialist · NPI 1992349427

Dominque Latreace Wathan, CMII, BHWC is a Peer Specialist in Shawnee, Oklahoma. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
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Practice location Address checks out

111 W 1st St
Shawnee, OK 74804-2202
Phone: (405) 273-1170
Fax: (405) 241-6447
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Case Manager/Care Coordinator (primary) Taxonomy 171M00000X
Peer Specialist Taxonomy 175T00000X

Record details

NPI number1992349427
Entity typeIndividual (Type 1)
GenderFemale
Credentials CMII , BHWC
Sole proprietorNo
NPI enumeratedOctober 28, 2019
Last updated in NPPESMarch 4, 2025
Certification dateMarch 4, 2025

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