Provider Demographics
NPI:1629201926
Name:PATRICIA WATSON AND ASSOCIATES
Entity Type:Organization
Organization Name:PATRICIA WATSON AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-756-7259
Mailing Address - Street 1:68-3582 MALINA ST
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-5354
Mailing Address - Country:US
Mailing Address - Phone:808-756-7259
Mailing Address - Fax:
Practice Address - Street 1:68-3582 MALINA ST
Practice Address - Street 2:
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738-5354
Practice Address - Country:US
Practice Address - Phone:808-756-7259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT242251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health