Provider Demographics
NPI:1679235428
Name:WATTERSON, KAYLYN L (PHD)
Entity Type:Individual
Prefix:DR
First Name:KAYLYN
Middle Name:L
Last Name:WATTERSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:WATTERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 CLARA BARTON DR # MC-164
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3472
Mailing Address - Country:US
Mailing Address - Phone:219-512-0924
Mailing Address - Fax:518-262-6111
Practice Address - Street 1:2 CLARA BARTON DR # MC-164
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3472
Practice Address - Country:US
Practice Address - Phone:518-262-5511
Practice Address - Fax:518-262-6111
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling