Individual
ANGELA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
555 N WOODLAWN ST STE 102, WICHITA, KS 67208-3671
(316) 652-2590
(316) 652-2595
Mailing address
555 N WOODLAWN ST STE 102, WICHITA, KS 67208-3671
(316) 652-2590
(316) 652-2595
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4257
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200556010B
—
KS
Enumeration date
06/19/2008
Last updated
12/06/2013
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