Individual
WANDA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
5600 US ROUTE 60, HUNTINGTON, WV 25705-2146
(304) 525-7851
(304) 399-1177
Mailing address
1143 DUNBAR AVE, DUNBAR, WV 25064-3121
(304) 766-7336
(304) 766-7334
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00944091
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
Enumeration date
04/16/2014
Last updated
04/16/2014
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