Individual
HEATHER RENEE' CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
15453 W VENTURA ST, SURPRISE, AZ 85379-8026
(623) 261-2730
Mailing address
15453 W VENTURA ST, SURPRISE, AZ 85379-8026
(623) 261-2730
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5617
AZ
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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