Provider Demographics
NPI:1881849990
Name:CHIBUNDI, MARY ANN (MS, OT)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:CHIBUNDI
Suffix:
Gender:F
Credentials:MS, OT
Other - Prefix:
Other - First Name:MARY ANN
Other - Middle Name:
Other - Last Name:SCHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OT
Mailing Address - Street 1:9108 TANGLEY LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-3372
Mailing Address - Country:US
Mailing Address - Phone:502-876-7661
Mailing Address - Fax:
Practice Address - Street 1:12523 TAYLORSVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-4400
Practice Address - Country:US
Practice Address - Phone:502-694-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY132065225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist