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Individual
MARY BRENT WATSON
Active
Individual
MARY BRENT WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA4494
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
883958100
—
FL
Enumeration date
03/25/2008
Last updated
06/09/2011
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