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Individual

TIFFANY NICOLE WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3341 S OATES ST, DOTHAN, AL 36301-5889
(850) 866-0441
Mailing address
3341 S OATES ST, DOTHAN, AL 36301-5889

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
23-253512
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
23-253512
AL
Enumeration date
01/26/2023
Last updated
01/26/2023
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