Provider Demographics
NPI:1518235688
Name:WATSON, VONZELLA LOVE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:VONZELLA
Middle Name:LOVE
Last Name:WATSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8014 STATE LINE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-3723
Mailing Address - Country:US
Mailing Address - Phone:913-534-8575
Mailing Address - Fax:
Practice Address - Street 1:8014 STATE LINE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:PRAIRIE VILLAGE
Practice Address - State:KS
Practice Address - Zip Code:66208-3723
Practice Address - Country:US
Practice Address - Phone:913-534-8575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2330106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist