Healthcare Provider Details

I. General information

NPI: 1124726302
Provider Name (Legal Business Name): TENAYA WATSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W WARM SPRINGS RD
HENDERSON NV
89014-3586
US

IV. Provider business mailing address

2375 E TROPICANA AVE STE 199
LAS VEGAS NV
89119-6564
US

V. Phone/Fax

Practice location:
  • Phone: 702-547-6700
  • Fax:
Mailing address:
  • Phone: 702-408-7123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License NumberSP-3406
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-3406
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: