Theodore Anthony Watson, LADC
Counselor, Addiction (Substance Use Disorder) in Omaha, NE. Individual provider (NPI-1).
NPI number1104981968
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1104981968
- Entity type
- Individual (NPI-1)
- Name
- Theodore Anthony Watson
- Credential
- LADC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 22, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 150 | NE | Yes |
Practice location
1941 S 42nd StSte 540
Omaha, NE 68105-2939
Phone 402-558-2034 · Fax 402-614-1540
Mailing address
1941 S 42nd StSte 540
Omaha, NE 68105-2939
Phone 402-558-2034 · Fax 402-614-1540
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