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Individual

MRS. JUNETTA WATSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
334 TIFTON ELDORADO RD, TIFTON, GA 31794-9497
(229) 391-2300
(229) 671-6774
Mailing address
3120 N OAK ST, VALDOSTA, GA 31602-1003
(229) 671-6100
(229) 671-6774

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
006968
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006968
LICENSE
GA
Enumeration date
10/11/2012
Last updated
10/11/2012
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