Individual
DENECIA DODSON WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 W KNOX ST, ENNIS, TX 75119-3966
(972) 872-3857
Mailing address
PO BOX 1831, BANDERA, TX 78003-1831
(936) 635-3077
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
104270
TX
235Z00000X
Speech-Language Pathologist
Primary
12683
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01027003
CERTIFICATE OF CLINICAL COMPETENCY - CCC-SLP
—
01
—
12683
STATE LICENSE NUMBER
TX
Enumeration date
11/17/2021
Last updated
10/18/2022
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