| Doctor Name: | LAWRENCE E. WATSON |
| NPI Number: | 1063558880 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 1719 |
| Business Practice Address: | 1310 N Hearne Ave Shreveport, LA - 711076516 |
| Business Phone Number: | 3186765147 |
| Business Fax Number: | 3186765137 |
| Mailing Address: | 1310 N Hearne Ave, SHREVEPORT |
| State: | LA |
| Postal Code: | 711076516 |
| Phone Number: | 3186765147 |
| Fax Number: | 3186765137 |
| NPI Enumeration Date: | 01/29/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 1719 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |