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Individual
DWIGHT EDMOND WATSON
Active
Individual
DWIGHT EDMOND WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MHP
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
004201075
LA
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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