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NPI Code Detail

MEDICARE: VANESSA WATSON

MEDICARE:   VANESSA  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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639964521
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA WATSON
Provider Business Mailing Address
First Line : 11576 NW 42ND ST
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33065-7168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11576 NW 42ND ST
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33065-7168
Country : US
Telephone Number : 954-505-0820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2025
Last Update Date : 04/11/2025

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Directions to “ VANESSA WATSON ” Practice Location

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