Individual
KELLE A WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC
Contact information
Practice address
780 LYNNHAVEN PKWY STE 110, VIRGINIA BEACH, VA 23452-7351
(757) 301-8747
Mailing address
780 LYNNHAVEN PKWY STE 110, VIRGINIA BEACH, VA 23452-7351
(757) 301-8747
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701005236
VA
101YP2500X
Professional Counselor
Primary
0701005236
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30015758110002
—
VA
Enumeration date
11/08/2005
Last updated
11/04/2024
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