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NPI Code Detail

MEDICARE: KRYSTAL MASHAY WATKINS

MEDICARE: KRYSTAL MASHAY WATKINS
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
1225X00000XOccupational Therapist0119007535VA
2225X00000XOccupational Therapist11454NC

General Provider Information

NPI Number : 1821502303
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL MASHAY WATKINS
Provider Business Mailing Address
First Line : 525 HIGHLAND PARK DR STE E
Second Line :
City : EDEN
State : NC
Zip : 27288-5063
Country : US
Telephone Number : 336-589-8530
Fax Number :
Provider Business Practice Location Address
First Line : 823 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1510
Country : US
Telephone Number : 336-900-1555
Fax Number : 336-332-2837
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2017
Last Update Date : 03/16/2026

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Directions to “ KRYSTAL MASHAY WATKINS ” Practice Location

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