Doctor Name: | MS. MALINDA RENEE WATSON |
NPI Number: | 1255481859 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | S2904 |
Business Practice Address: | 1830 Manor Place Dr Hernando, MS - 386321648 |
Business Phone Number: | 6622092544 |
Business Fax Number: | |
Mailing Address: | 1830 Manor Place Dr, HERNANDO |
State: | MS |
Postal Code: | 386321648 |
Phone Number: | 6019908839 |
Fax Number: | |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 06/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S2904 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |