Individual
MRS. STEPHANIE M. WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAMFC, LPCI
Contact information
Practice address
5611 HIGHWAY 80 E, PEARL, MS 39208-8929
(601) 939-6634
Mailing address
512 WINDSOR DR, BRANDON, MS 39047-7770
(601) 992-7071
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
4781
SC
Other
Enumeration date
02/10/2007
Last updated
11/15/2010
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