Individual
LISA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
405 8TH AVE SW, MANDAN, ND 58554-4030
(701) 663-7514
Mailing address
3001 VALLEY VIEW LN N, MANDAN, ND 58554-8148
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
699
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
52456
—
ND
Enumeration date
01/22/2007
Last updated
07/08/2007
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