Individual
CHESNEY CHELLISE HATCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
1500 CAMEO ST, CLOVIS, NM 88101-5476
(575) 607-6586
Mailing address
537 NM HIGHWAY 88, PORTALES, NM 88130-9776
(575) 607-6586
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
Primary
OT-2024-0102
NM
Other
Enumeration date
08/12/2020
Last updated
07/29/2024
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