Provider Demographics
NPI:1356994198
Name:EDMONSON-WATSON, RACHEL A
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:A
Last Name:EDMONSON-WATSON
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 1:237 N LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-1211
Mailing Address - Country:US
Mailing Address - Phone:267-467-3515
Mailing Address - Fax:
Practice Address - Street 1:320 MACDADE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:COLLINGDALE
Practice Address - State:PA
Practice Address - Zip Code:19023-1926
Practice Address - Country:US
Practice Address - Phone:610-522-4506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-21
Last Update Date:2019-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health