Basic Information
| Provider Information | |||||||||
| NPI: | 1942549928 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WATSON | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | CAROLINE | ||||||||
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| Credential: | MS CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1099 GOLD CAMP RD | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750331422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4696330700 | ||||||||
| FaxNumber: | 9724225275 | ||||||||
| Practice Location | |||||||||
| Address1: | 3880 PARKWOOD BLVD | ||||||||
| Address2: | |||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750341928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146188170 | ||||||||
| FaxNumber: | 2146188171 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2013 | ||||||||
| LastUpdateDate: | 02/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 17192 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.