Individual
CHARLENE DENISE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4118 LESLIE LN, PANAMA CITY, FL 32404-6247
(850) 257-5176
(850) 257-5176
Mailing address
4118 LESLIE LN, PANAMA CITY, FL 32404-6247
(850) 257-5176
(850) 257-5176
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
374P1801X
FL
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
683204198
683204196
FL
Enumeration date
12/20/2010
Last updated
12/20/2010
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