MEDICARE: MS. SANDRA HITCHCOCK WATSON LPC

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	101YP2500X	Professional Counselor	797	AL

General Provider Information

NPI Number	:	1477625739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA HITCHCOCK WATSON LPC

Provider Business Mailing Address
First Line	:	3 OFFICE PARK CIRCLE
Second Line	:	SUITE 102
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223-2534
Country	:	US
Telephone Number	:	205-567-1850
Fax Number	:	205-967-4842

Provider Business Practice Location Address
First Line	:	3 OFFICE PARK CIRCLE
Second Line	:	SUITE 102
City	:	BIRMINGHAM
State	:	AL
Zip	:	35223-2534
Country	:	US
Telephone Number	:	205-567-1850
Fax Number	:	205-967-4842

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/08/2007

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