Healthcare Provider Details

I. General information

NPI: 1679180608
Provider Name (Legal Business Name): LEA OT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 NORTH TURNER STREET
HOBBS NM
88240
US

IV. Provider business mailing address

320 N TURNER ST
HOBBS NM
88240-8302
US

V. Phone/Fax

Practice location:
  • Phone: 575-964-5109
  • Fax: 575-616-7005
Mailing address:
  • Phone: 801-592-2907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHANTEL MILLER BENNETT
Title or Position: OWNER
Credential: OTR
Phone: 801-592-2907