Provider Demographics
NPI:1174979314
Name:WATSON, BRANDON (BSW)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:WATSON
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 PITTSBURGH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8407
Mailing Address - Country:US
Mailing Address - Phone:724-912-6800
Mailing Address - Fax:724-550-4117
Practice Address - Street 1:1023 PITTSBURGH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8407
Practice Address - Country:US
Practice Address - Phone:724-912-6800
Practice Address - Fax:724-550-4117
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor