1922363597 NPI number — MS. LEANNE LOUISE CHATTEY CTP

Table of content: MS. LEANNE LOUISE CHATTEY CTP (NPI 1922363597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922363597 NPI number — MS. LEANNE LOUISE CHATTEY CTP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHATTEY
Provider First Name:
LEANNE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CTP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922363597
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 BRIMHALL WASH
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANTE FE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-795-4354
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2905 RODEO PARK DR E BLDG 3
Provider Second Line Business Practice Location Address:
SANTE FE SOUL HEALTH AND HEALING CENTER
Provider Business Practice Location Address City Name:
SANTA FE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87505-6313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-474-8885
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)