Provider Demographics
NPI:1245016575
Name:CHAVARRIA-LESLIE, ISELA MAYARI (MA, MSW)
Entity type:Individual
Prefix:MRS
First Name:ISELA
Middle Name:MAYARI
Last Name:CHAVARRIA-LESLIE
Suffix:
Gender:F
Credentials:MA, MSW
Other - Prefix:MS
Other - First Name:ISELA
Other - Middle Name:MAYARI
Other - Last Name:CHAVARRIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:650 E APACHE CIR
Mailing Address - Street 2:
Mailing Address - City:BENSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85602-7030
Mailing Address - Country:US
Mailing Address - Phone:520-686-3816
Mailing Address - Fax:
Practice Address - Street 1:650 E APACHE CIR
Practice Address - Street 2:
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602-7030
Practice Address - Country:US
Practice Address - Phone:520-686-3816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-04
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker