Kathy Ann Watson, MS CCC/SLP
Individual provider Active NPI Speech-Language Pathologist · Bismarck, IL
NPI 1578072047 · NPPES record last updated Sep 27, 2017
Key facts
- NPI
- 1578072047
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.004816 (IL)
- Practice address
- 17268 E 2750 North Rd
Bismarck, IL 61814-5130 - Phone
- (217) 759-7251
- NPI assigned
- Sep 27, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.004816 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.004816 | IL | Yes |
Addresses
Primary practice location
17268 E 2750 North Rd
Bismarck, IL 61814-5130
Mailing address
PO Box 350
Bismarck, IL 61814-0350
Phone (217) 759-7251
Other providers in Bismarck, IL
- Community Unit School Dist 1
- Maya Elrose Durfee O'Brien
- Michael Henry
- Garry James Hinkle I
- Amanda Suzanne Potter
All providers in Bismarck, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.