MEDICARE: SANDRA STEINER WATSON PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0003325	FL

General Provider Information

NPI Number	:	1174502215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA STEINER WATSON PH.D.

Provider Business Mailing Address
First Line	:	900 E OCEAN BLVD
Second Line	:	F253
City	:	STUART
State	:	FL
Zip	:	34994-2471
Country	:	US
Telephone Number	:	772-287-7471
Fax Number	:	772-287-7471

Provider Business Practice Location Address
First Line	:	900 E OCEAN BLVD
Second Line	:	F253
City	:	STUART
State	:	FL
Zip	:	34994-2471
Country	:	US
Telephone Number	:	772-287-7471
Fax Number	:	772-287-7471

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	07/08/2007

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