Individual
DOROTHY WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNA, CMT, TME, DSP.
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
—
—
376K00000X
Nurse's Aide
Primary
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760747174
MEDICARE
MD
Enumeration date
07/11/2012
Last updated
08/08/2014
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