Individual
LEA DONOVAN WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC, CERT AVT
Contact information
Practice address
544 WASHINGTON ST, GLOUCESTER, MA 01930-1771
(978) 282-0025
Mailing address
544 WASHINGTON ST, GLOUCESTER, MA 01930-1771
(978) 282-0025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1505
MA
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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