Doctor Name: | JONI LYNN WATKINS |
NPI Number: | 1740400761 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW |
License Number: | AP00942899 |
Business Practice Address: | Rr 1 Box 256a Triadelphia, WV - 260599725 |
Business Phone Number: | 3045479197 |
Business Fax Number: | |
Mailing Address: | Rr 1 Box 256a, TRIADELPHIA |
State: | WV |
Postal Code: | 260599725 |
Phone Number: | 3045479197 |
Fax Number: | |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | AP00942899 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |