Provider Demographics
NPI:1437340866
Name:WATKINS, BESSIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BESSIE
Middle Name:
Last Name:WATKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:BESSIE
Other - Middle Name:
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:112 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1303
Mailing Address - Country:US
Mailing Address - Phone:201-489-6760
Mailing Address - Fax:201-489-5214
Practice Address - Street 1:112 BUCKINGHAM DR
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1303
Practice Address - Country:US
Practice Address - Phone:201-489-6760
Practice Address - Fax:201-489-5214
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00405600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical