Provider Demographics
NPI:1902088875
Name:WATSON, BECKY H (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BECKY
Middle Name:H
Last Name:WATSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6385 TRUDY DR
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-2622
Mailing Address - Country:US
Mailing Address - Phone:404-597-3764
Mailing Address - Fax:678-349-0633
Practice Address - Street 1:5415 THOMPSON MILL RD
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-4038
Practice Address - Country:US
Practice Address - Phone:404-597-3764
Practice Address - Fax:678-349-0633
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional