Individual
JENNIFER J. WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10755 AMBASSADOR DR STE 201, MANASSAS, VA 20109-2527
(715) 589-3907
Mailing address
1000 JEFFERSON ST STE 1B, LYNCHBURG, VA 24504-1724
(434) 485-5500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008550
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083992762
—
IL
Enumeration date
07/28/2011
Last updated
11/05/2019
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