Provider Demographics
NPI:1427253491
Name:WATSON, BOBBIE JEAN (LPC)
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:JEAN
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 1:802 N KENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-2623
Mailing Address - Country:US
Mailing Address - Phone:903-748-5599
Mailing Address - Fax:903-223-9555
Practice Address - Street 1:309 COUNTY ROAD 2311
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-6313
Practice Address - Country:US
Practice Address - Phone:903-748-5599
Practice Address - Fax:903-223-9555
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15177101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional