Provider Demographics
NPI:1780071803
Name:WATSON, DONNA LEAH (LCSW)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:LEAH
Last Name:WATSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 GOYA CT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4522
Mailing Address - Country:US
Mailing Address - Phone:850-206-4845
Mailing Address - Fax:850-438-4649
Practice Address - Street 1:7100 PLANTATION RD STE 11
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-6234
Practice Address - Country:US
Practice Address - Phone:850-206-4845
Practice Address - Fax:850-438-4649
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 122101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical