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NPI Code Detail

MEDICARE: ALYXZANDRIA WATSON

MEDICARE: ALYXZANDRIA 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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1841070216
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYXZANDRIA WATSON
Provider Business Mailing Address
First Line : 2009 OSPREY LN
Second Line :
City : LUTZ
State : FL
Zip : 33549-9374
Country : US
Telephone Number : 813-768-0711
Fax Number :
Provider Business Practice Location Address
First Line : 2009 OSPREY LN
Second Line :
City : LUTZ
State : FL
Zip : 33549-9374
Country : US
Telephone Number : 813-768-0711
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2023
Last Update Date : 10/03/2023

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Directions to “ ALYXZANDRIA WATSON ” Practice Location

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