Healthcare Provider Details

I. General information

NPI: 1881361137
Provider Name (Legal Business Name): PEARL WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 TULANE AVE STE 945
NEW ORLEANS LA
70119-7578
US

IV. Provider business mailing address

344 SAINT JOSEPH ST APT 429
NEW ORLEANS LA
70130-3652
US

V. Phone/Fax

Practice location:
  • Phone: 504-821-2232
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: