Individual
MRS. GRAYSON KOONTZ WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, SLP-CCC
Contact information
Practice address
121 MCIVER ST, CHERAW, SC 29520-1728
(843) 680-1372
Mailing address
121 MCIVER ST, CHERAW, SC 29520-1728
(843) 921-1030
(843) 921-1036
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12113169
SC
Other
Enumeration date
01/30/2013
Last updated
01/30/2013
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