Individual
SHIMARA WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
76 SISTERS FARMSTEAD DR, MOUNT LAUREL, NJ 08054-1448
(347) 458-5494
Mailing address
309 FELLOWSHIP RD, EAST GATE CENTER, 200, MOUNT LAUREL, NJ 08054-1448
(347) 458-5494
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NJ
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
NJ
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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