Individual
SHANNON WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1061 BAYVIEW ST, HOLLY HILL, SC 29059-8583
(803) 971-0689
Mailing address
1061 BAYVIEW ST, HOLLY HILL, SC 29059-8583
(803) 971-0689
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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