Provider Demographics
NPI:1366503781
Name:WATSON, BOLYN E (BA SOCIOLOGY)
Entity Type:Individual
Prefix:
First Name:BOLYN
Middle Name:E
Last Name:WATSON
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Gender:M
Credentials:BA SOCIOLOGY
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:479 THOMAS JONES WAY
Mailing Address - Street 2:SUITE 800
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-648-1130
Mailing Address - Fax:610-560-8219
Practice Address - Street 1:479 THOMAS JONES WAY
Practice Address - Street 2:SUITE 800
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-648-1130
Practice Address - Fax:610-560-8219
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)