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NPI Code Detail

MEDICARE: TENILLE KOTHE

MEDICARE: TENILLE KOTHE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639897606
Entity Type Code : Individual
Provider Name (Legal Business Name) : TENILLE KOTHE
Provider Business Mailing Address
First Line : 7260 W AZURE DR STE 140-104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-7999
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7570 NORMAN ROCKWELL LN STE 250
Second Line :
City : LAS VEGAS
State : NV
Zip : 89143-6013
Country : US
Telephone Number : 702-848-2980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2022
Last Update Date : 08/16/2022

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Directions to “ TENILLE KOTHE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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