Provider Demographics
NPI:1104586825
Name:CHANEY, DENA RACHELLE (COTA)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:RACHELLE
Last Name:CHANEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:RACHELLE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:1108 WHITLEY DR
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-7796
Mailing Address - Country:US
Mailing Address - Phone:512-648-7890
Mailing Address - Fax:
Practice Address - Street 1:310 CHISHOLM TRAIL RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-5076
Practice Address - Country:US
Practice Address - Phone:512-982-0245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210064224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant