Basic Information
Provider Information
NPI: 1003154477
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WATSON
FirstName: ALELIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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OtherLastName:  
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Mailing Information
Address1: 7100 WESTVIEW DR APT 1618
Address2:  
City: HOUSTON
State: TX
PostalCode: 770556971
CountryCode: US
TelephoneNumber: 8327461578
FaxNumber:  
Practice Location
Address1: 16219 GREENPORT LN
Address2:  
City: HOUSTON
State: TX
PostalCode: 770846781
CountryCode: US
TelephoneNumber: 8327461578
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/19/2013
LastUpdateDate: 05/31/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health
106H00000X  N Behavioral Health & Social Service ProvidersMarriage & Family Therapist 

No ID Information.


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