Provider Demographics
NPI:1073669396
Name:WATSON, MARIA RHEA (MACCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:RHEA
Last Name:WATSON
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-1942
Mailing Address - Country:US
Mailing Address - Phone:956-655-8460
Mailing Address - Fax:
Practice Address - Street 1:3106 FOREST CT
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78574-1942
Practice Address - Country:US
Practice Address - Phone:956-655-8460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18472235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX18472OtherTEXAS STATE BOARD-SLP