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General NPI Number Information
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NPI Number | 1205473360
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Entity Type | Individual
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Provider Name | KEONNA M WATSON DSOCSCI, MS, BCHHP
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Gender | Female
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 3125 NEW CASTLE AVE STE 3
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City | NEW CASTLE
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State | DE
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Zip | 19720-2174
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Country | US
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Telephone | 302-277-7161
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Fax | 302-566-2853
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Provider Business Mailing Address
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Address Line | 411 ROLLING GREEN AVE
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City | NEW CASTLE
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State | DE
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Zip | 19720-4791
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Country | US
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Telephone | 302-277-7161
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Fax | 302-566-2853
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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Taxonomy #4
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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