Provider Demographics
NPI:1205645140
Name:WATLINGTON, SHJON DANIEL
Entity type:Individual
Prefix:
First Name:SHJON
Middle Name:DANIEL
Last Name:WATLINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 KNOLLWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-5532
Mailing Address - Country:US
Mailing Address - Phone:484-225-2800
Mailing Address - Fax:
Practice Address - Street 1:224 NAZARETH PIKE
Practice Address - Street 2:TROLLEY STATION MALL, SUITE 22A
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064
Practice Address - Country:US
Practice Address - Phone:610-365-8373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH007521106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician