Doctor Name: | MR. MARCUS DAYON WATKINS |
NPI Number: | 1154646362 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPCA |
License Number: | A7823 |
Business Practice Address: | 608 Jackson St Suite B Roanoke Rapids, NC - 278702600 |
Business Phone Number: | 2525374005 |
Business Fax Number: | |
Mailing Address: | 608 Jackson St, Suite B ROANOKE RAPIDS |
State: | NC |
Postal Code: | 278702600 |
Phone Number: | 2525374005 |
Fax Number: | |
NPI Enumeration Date: | 03/30/2010 |
NPI Last Update Date: | 03/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | A7823 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |