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General NPI Number Information
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NPI Number | 1861159527
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Entity Type | Individual
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Provider Name | DENECIA DODSON WATSON
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Gender | Female
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Dates
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Enumeration Date | 11/17/2021
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Last Update Date | 10/18/2022
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Provider Practice Location Address
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Address Line | 303 W KNOX ST
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City | ENNIS
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State | TX
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Zip | 75119-3966
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Country | US
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Telephone | 972-872-3857
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1831
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City | BANDERA
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State | TX
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Zip | 78003-1831
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Country | US
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Telephone | 936-635-3077
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Fax |
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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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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 104270
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12683
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License Number State | TX
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