Individual
SIERRA D WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Mailing address
3341 NORTHVIEW DR, JACKSON, MS 39216-3110
(662) 607-0430
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
19-87447
MS
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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