Provider Demographics
NPI:1093148389
Name:DUGAR, CHALYA RADER (LOTR)
Entity Type:Individual
Prefix:MRS
First Name:CHALYA
Middle Name:RADER
Last Name:DUGAR
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:CHALYA
Other - Middle Name:SHACONNE
Other - Last Name:RADER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LOTR
Mailing Address - Street 1:102 SPANISH OAK DR
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-5778
Mailing Address - Country:US
Mailing Address - Phone:337-380-6539
Mailing Address - Fax:
Practice Address - Street 1:102 SPANISH OAK DR
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-5778
Practice Address - Country:US
Practice Address - Phone:337-380-6539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z12376225XF0002X, 225XL0004X, 225XG0600X, 225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics