| Doctor Name: | DR. DONALD JAMES WATERMAN |
| NPI Number: | 1003968827 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 2604 |
| Business Practice Address: | 5001 Highway 190 East Service Rd Ste C1 Covington, LA - 704334949 |
| Business Phone Number: | 9856268700 |
| Business Fax Number: | 9858922055 |
| Mailing Address: | 5001 Highway 190 East Service Rd Ste C1, COVINGTON |
| State: | LA |
| Postal Code: | 704334949 |
| Phone Number: | 9856268700 |
| Fax Number: | 9858922055 |
| NPI Enumeration Date: | 01/18/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2604 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |