Provider Demographics
NPI:1437180643
Name:WATSON, KENYA N (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KENYA
Middle Name:N
Last Name:WATSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 CURVEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7128
Mailing Address - Country:US
Mailing Address - Phone:803-736-2870
Mailing Address - Fax:
Practice Address - Street 1:307 CURVEWOOD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7128
Practice Address - Country:US
Practice Address - Phone:803-736-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3777235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist