Individual
DESTINY LO'REALLE WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
812 GENERAL PERSHING ST, NEW ORLEANS, LA 70115-2732
(504) 270-9952
Mailing address
2637 ONZAGA ST, NEW ORLEANS, LA 70119-2223
(504) 270-9952
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
LA
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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