Provider Demographics
NPI:1962221663
Name:DUNCAN, AINSLEY MARIE (OTR)
Entity type:Individual
Prefix:
First Name:AINSLEY
Middle Name:MARIE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12101 RIDGEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:KY
Mailing Address - Zip Code:40026-9451
Mailing Address - Country:US
Mailing Address - Phone:502-718-2047
Mailing Address - Fax:
Practice Address - Street 1:10300 BUNSEN WAY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2508
Practice Address - Country:US
Practice Address - Phone:502-495-1662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY464944225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist