MEDICARE: MS. CHRISTINE LYNN WATSON

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
1	101YP2500X	Professional Counselor	11180	OK
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1770804726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CHRISTINE LYNN WATSON

Provider Business Mailing Address
First Line	:	1429 NW 92ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-1312
Country	:	US
Telephone Number	:	405-842-4147
Fax Number	:

Provider Business Practice Location Address
First Line	:	1429 NW 92ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-1312
Country	:	US
Telephone Number	:	405-842-4147
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2010
Last Update Date	:	08/15/2025

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