MEDICARE: MALEETA AYRESCE WATSON

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1396441739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALEETA AYRESCE WATSON

Provider Business Mailing Address
First Line	:	6611 KRAUSE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-3506
Country	:	US
Telephone Number	:	281-682-6591
Fax Number	:

Provider Business Practice Location Address
First Line	:	6611 KRAUSE DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-3506
Country	:	US
Telephone Number	:	281-682-6591
Fax Number	:

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

Provider Enumeration Date	:	02/07/2023
Last Update Date	:	04/12/2024

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Directions to “ MALEETA AYRESCE WATSON ” Practice Location

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