MEDICARE: MS. ASHLEIGH PATRICIA WATSON MA, BCBA

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	103K00000X	Behavior Analyst	1-16-24494	NJ

General Provider Information

NPI Number	:	1558880369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEIGH PATRICIA WATSON MA, BCBA

Provider Business Mailing Address
First Line	:	112 E CEDAR AVE
Second Line	:
City	:	HADDON TWP
State	:	NJ
Zip	:	08107-1010
Country	:	US
Telephone Number	:	609-230-8266
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 E CEDAR AVE
Second Line	:
City	:	HADDON TWP
State	:	NJ
Zip	:	08107-1010
Country	:	US
Telephone Number	:	609-230-8266
Fax Number	:

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

Provider Enumeration Date	:	09/12/2017
Last Update Date	:	07/21/2022

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