| R Glen Watson, Lcsw Inc. | |
|
250 Cushman St Suite 3-e Fairbanks AK 99701-4640 | |
| (907) 479-0411 | |
| Not Available |
| Full Name | R Glen Watson, Lcsw Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 250 Cushman St, Fairbanks, Alaska |
| Authorized Official Name and Position | Roy Glen Watson (PRESIDENT) |
| Authorized Official Contact | 9074790411 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R Glen Watson, Lcsw Inc. 250 Cushman St Suite 3-e Fairbanks AK 99701-4640 Ph: (907) 479-0411 | R Glen Watson, Lcsw Inc. 250 Cushman St Suite 3-e Fairbanks AK 99701-4640 Ph: (907) 479-0411 |
| NPI Number | 1194094268 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 12/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194094268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 161 (Alaska) | Primary |
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