Provider Demographics
NPI:1265681639
Name:WATSON, CURTIS VAN JR
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:VAN
Last Name:WATSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2188 58TH ST N
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-3112
Mailing Address - Country:US
Mailing Address - Phone:727-535-9811
Mailing Address - Fax:727-530-7423
Practice Address - Street 1:2188 58TH ST N
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-3112
Practice Address - Country:US
Practice Address - Phone:727-535-9811
Practice Address - Fax:727-530-7423
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health