Provider Demographics
NPI:1841455599
Name:WATSON, DAYNA MALIA (LAPC)
Entity type:Individual
Prefix:MISS
First Name:DAYNA
Middle Name:MALIA
Last Name:WATSON
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 WEST ST.
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819
Mailing Address - Country:US
Mailing Address - Phone:229-243-1633
Mailing Address - Fax:
Practice Address - Street 1:410 WEST ST.
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819
Practice Address - Country:US
Practice Address - Phone:229-243-1633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001732101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor