Provider Demographics
NPI:1558793349
Name:WATSON, MERRY FAITH (MHPP)
Entity Type:Individual
Prefix:MS
First Name:MERRY
Middle Name:FAITH
Last Name:WATSON
Suffix:
Gender:F
Credentials:MHPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 S MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:BERRYVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72616-4330
Mailing Address - Country:US
Mailing Address - Phone:870-423-1077
Mailing Address - Fax:
Practice Address - Street 1:1004 S MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:BERRYVILLE
Practice Address - State:AR
Practice Address - Zip Code:72616-4330
Practice Address - Country:US
Practice Address - Phone:870-423-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor