Provider Demographics
NPI:1326511551
Name:CHAVEZ, LEILA ROSEMARY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:LEILA
Middle Name:ROSEMARY
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:LEILA
Other - Middle Name:ROSEMARY
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:6408 LONGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CAMMACK VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72207-2723
Mailing Address - Country:US
Mailing Address - Phone:501-539-7547
Mailing Address - Fax:
Practice Address - Street 1:400 NATURAL RESOURCES DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1501
Practice Address - Country:US
Practice Address - Phone:501-687-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2934225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist