Doctor Name: | MR. TERRILL PAUL WATSON |
NPI Number: | 1407985229 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 1472 |
Business Practice Address: | 4110 Hobby Horse Ln Skiatook, OK - 740709361 |
Business Phone Number: | 9187244779 |
Business Fax Number: | 9183967929 |
Mailing Address: | 4110 Hobby Horse Ln, SKIATOOK |
State: | OK |
Postal Code: | 740709361 |
Phone Number: | 9187244779 |
Fax Number: | 9183967929 |
NPI Enumeration Date: | 03/05/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1472 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |