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General NPI Number Information
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NPI Number | 1780129510
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Entity Type | Organization
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Legal Business Name | WATSON PSYCHOLOGICAL SERVICES, PLLC
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 01/03/2017
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Provider Practice Location Address
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Address Line | 5500 MAIN ST SUITE 308
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-6755
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Country | US
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Telephone | 716-634-1184
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Fax |
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Provider Business Mailing Address
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Address Line | 6045 LONG ST
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City | CLARENCE CENTER
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State | NY
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Zip | 14032-9725
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. HEATHER WATSON
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Credential |
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Telephone | 716-249-0535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 020568
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License Number State | NY
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