Individual
MR. KYLE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1505 E BRADFORD PKWY, SPRINGFIELD, MO 65804-6566
(417) 322-6622
(417) 350-1935
Mailing address
3600 S NATIONAL AVE, SPRINGFIELD, MO 65807-7311
(417) 322-6622
(417) 350-1935
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2015031019
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
830101319
—
MO
Enumeration date
09/08/2015
Last updated
03/01/2023
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