Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OTT.Z12376 | LA |
N | 225XF0002X | Feeding, Eating & Swallowing | OTT.Z12376 | LA |
N | 225XG0600X | Occupational Therapist - Gerontology | OTT.Z12376 | LA |
N | 225XL0004X | Low Vision | OTT.Z12376 | LA |
N | 225XP0200X | Occupational Therapist - Pediatrics | OTT.Z12376 | LA |
NPI | 1093148389 |
---|---|
Provider Name | Mrs. Chalya Rader Dugar |
First Address | Carencro, LA 70520-5778 |
Second Address | Carencro, LA 70520-5778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2013 |
Last Update Date | 09/08/2013 |