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NPI Code Detail

MEDICARE: ELEANOR G WATSON LPC

MEDICARE: ELEANOR G WATSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor1783MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11783OTHERMSLICENSED PROFESSIONAL COUNSELOR

General Provider Information

NPI Number : 1104907302
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELEANOR G WATSON LPC
Provider Business Mailing Address
First Line : 152 HIGHWAY 7 S
Second Line :
City : OXFORD
State : MS
Zip : 38655-5392
Country : US
Telephone Number : 662-234-7521
Fax Number : 662-236-3071
Provider Business Practice Location Address
First Line : 152 HIGHWAY 7 S
Second Line :
City : OXFORD
State : MS
Zip : 38655-5392
Country : US
Telephone Number : 662-234-7521
Fax Number : 662-236-3071
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 03/06/2014

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Directions to “ ELEANOR G WATSON LPC” Practice Location

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