Healthcare Provider Details

I. General information

NPI: 1942758842
Provider Name (Legal Business Name): MRS. SARAH WARD-WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2016
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 GEORGES CT
WATERBURY CT
06708-1865
US

IV. Provider business mailing address

51 GEORGES CT
WATERBURY CT
06708-1865
US

V. Phone/Fax

Practice location:
  • Phone: 203-650-2970
  • Fax:
Mailing address:
  • Phone: 203-650-2970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: