Provider Demographics
NPI:1770822009
Name:WATSON, EMILY JEAN (LMFT)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:JEAN
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 1:6336 HALIFAX RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76116-2067
Mailing Address - Country:US
Mailing Address - Phone:817-440-7108
Mailing Address - Fax:
Practice Address - Street 1:6336 HALIFAX RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-2067
Practice Address - Country:US
Practice Address - Phone:817-440-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109060106H00000X
TX204032106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist