Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY7111 | |
Y | 103G00000X | Clinical Psychologist | PY7111 | FL |
Y | 103TC0700X | Clinical Psychologist | PY7111 | FL |
N | 103TH0004X | Health Psychologist | PY7111 |
NPI | 1235390352 |
---|---|
Provider Name | Dr. Jennifer M Watson |
First Address | Gainesville, FL 32608-8108 |
Second Address | Gainesville, FL 32608-8108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2008 |
Last Update Date | 03/06/2020 |