Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | WV |
NPI | 1003089277 |
---|---|
Provider Name | Chloe Ann Watson |
First Address | Morgantown, WV 26501-7546 |
Second Address | Morgantown, WV 26501-7546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 09/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810002021 | (05) | WV |