Provider Demographics
NPI:1528019718
Name:CHESTNUT, CHENIN KAE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CHENIN
Middle Name:KAE
Last Name:CHESTNUT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11630 SANDWOOD CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46235-6038
Mailing Address - Country:US
Mailing Address - Phone:317-716-8226
Mailing Address - Fax:317-823-2414
Practice Address - Street 1:9505 E 59TH ST
Practice Address - Street 2:SUITE B1
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46216-1025
Practice Address - Country:US
Practice Address - Phone:317-716-8226
Practice Address - Fax:317-823-2414
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist