Provider Demographics
NPI:1194842302
Name:CHAVEZ, LOUISE CLAIRE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:CLAIRE
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 MONTCLAIRE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-6130
Mailing Address - Country:US
Mailing Address - Phone:505-299-0512
Mailing Address - Fax:
Practice Address - Street 1:500 LASER DR NE
Practice Address - Street 2:RIO RANCHO PUBLIC SCHOOLS
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4517
Practice Address - Country:US
Practice Address - Phone:505-896-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1108225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist