Provider Demographics
NPI:1427085125
Name:WATSON, KRIS A (MA, CCC-A)
Entity type:Individual
Prefix:MS
First Name:KRIS
Middle Name:A
Last Name:WATSON
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 S BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6137
Mailing Address - Country:US
Mailing Address - Phone:405-340-9191
Mailing Address - Fax:405-340-9185
Practice Address - Street 1:2801 S BRYANT AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6137
Practice Address - Country:US
Practice Address - Phone:405-340-9191
Practice Address - Fax:405-340-9185
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK165237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter