Individual
MS. TANYA EILEEN WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
1815 WELLS ST, RM 202, LAS CRUCES, NM 88003-1304
(575) 646-7182
(575) 646-3564
Mailing address
PO BOX 30001, MSC 3FAC, LAS CRUCES, NM 88003-8001
(575) 646-7182
(575) 646-3435
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
611
NM
Other
Enumeration date
06/09/2014
Last updated
01/14/2015
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