Provider Demographics
NPI:1053673210
Name:WATSON, TERRY ANN (MS,MA,CMT,LCAT)
Entity Type:Individual
Prefix:MS
First Name:TERRY
Middle Name:ANN
Last Name:WATSON
Suffix:
Gender:F
Credentials:MS,MA,CMT,LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 WESTMINSTER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-6036
Mailing Address - Country:US
Mailing Address - Phone:917-848-7620
Mailing Address - Fax:
Practice Address - Street 1:506 WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-6036
Practice Address - Country:US
Practice Address - Phone:917-848-7620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist