Provider Demographics
NPI:1477625739
Name:WATSON, SANDRA HITCHCOCK (LPC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:HITCHCOCK
Last Name:WATSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 OFFICE PARK CIRCLE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35223-2534
Mailing Address - Country:US
Mailing Address - Phone:205-567-1850
Mailing Address - Fax:205-967-4842
Practice Address - Street 1:3 OFFICE PARK CIRCLE
Practice Address - Street 2:SUITE 102
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35223-2534
Practice Address - Country:US
Practice Address - Phone:205-567-1850
Practice Address - Fax:205-967-4842
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL797101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional