Provider Demographics
NPI:1184898611
Name:WATERSON, DOROTHY R
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:R
Last Name:WATERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 WILLOW RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27332-6903
Mailing Address - Country:US
Mailing Address - Phone:919-718-5949
Mailing Address - Fax:919-718-5949
Practice Address - Street 1:80 EAST ST
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5761
Practice Address - Country:US
Practice Address - Phone:919-542-8271
Practice Address - Fax:919-542-2473
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker