Provider Demographics
NPI:1922363597
Name:CHATTEY, LEANNE LOUISE (CTP)
Entity Type:Individual
Prefix:MS
First Name:LEANNE
Middle Name:LOUISE
Last Name:CHATTEY
Suffix:
Gender:F
Credentials:CTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRIMHALL WASH
Mailing Address - Street 2:
Mailing Address - City:SANTE FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508
Mailing Address - Country:US
Mailing Address - Phone:505-795-4354
Mailing Address - Fax:
Practice Address - Street 1:2905 RODEO PARK DR E BLDG 3
Practice Address - Street 2:SANTE FE SOUL HEALTH AND HEALING CENTER
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-6313
Practice Address - Country:US
Practice Address - Phone:505-474-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy