Individual
MR. LUCAS NATHANIEL WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
34132 HWY 28 EAST, CRYSTAL SPRINGS, MS 39059
(601) 894-1323
(601) 968-0079
Mailing address
PO BOX 847, HAZELHURST, MS 39083-0847
(601) 894-1323
(601) 968-0079
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M0861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07108853
—
MS
Enumeration date
07/03/2007
Last updated
07/08/2007
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