Provider Demographics
NPI:1396107843
Name:WATSON, THOMAS HIOTT III (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:HIOTT
Last Name:WATSON
Suffix:III
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 OBRIAN DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-3858
Mailing Address - Country:US
Mailing Address - Phone:828-465-7326
Mailing Address - Fax:
Practice Address - Street 1:1350 OBRIAN DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-3858
Practice Address - Country:US
Practice Address - Phone:828-465-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-23
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3877235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist