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General NPI Number Information
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NPI Number | 1457999120
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Entity Type | Individual
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Provider Name | HAYDEN LOUIS CHENAULT OTDR/L
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Gender | Male
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 12/12/2019
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Provider Practice Location Address
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Address Line | 6124 NORTHMOOR DR
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City | LITTLE ROCK
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State | AR
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Zip | 72204-2504
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Country | US
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Telephone | 501-687-2000
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Fax | 501-687-1999
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Provider Business Mailing Address
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Address Line | 600 MAPLE ST APT 3207
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City | N LITTLE ROCK
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State | AR
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Zip | 72114-5486
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Country | US
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Telephone | 501-215-1654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OTR3346
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License Number State | AR
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