Individual
TAKIESHA N WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2916 LINDSEY DR, COPPERAS COVE, TX 76522-7524
(254) 554-2976
Mailing address
2916 LINDSEY DR, COPPERAS COVE, TX 76522-7524
(254) 554-1976
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
76992
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76992
STATE LICENSE NUMBER
TX
Enumeration date
05/12/2020
Last updated
05/12/2020
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