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Individual

RICHARD A WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5675 FAIRVIEW ST, STEVENSVILLE, MI 49127-1033
(269) 429-7727
(269) 429-5754
Mailing address
5675 FAIRVIEW ST, STEVENSVILLE, MI 49127-1033
(269) 429-7727
(269) 429-5754

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
6401009577
MI
103T00000X
Psychologist
Primary
6301012216
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P208915080
BLUE CROSS PIN
MI
Enumeration date
09/20/2006
Last updated
12/05/2008
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