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NPI 1588917595

NPI 1588917595 : AMBER FAYE RUPERT MS, OTR/L, CKTP, CDP : BOONSBORO, MD

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General NPI Number Information
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    NPI Number           |    1588917595
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    Entity Type          |    Individual 
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    Provider Name        |    AMBER FAYE RUPERT MS, OTR/L, CKTP, CDP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/16/2012
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    Last Update Date     |    04/03/2019
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Provider Practice Location Address
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    Address Line         |    8507 MAPLEVILLE RD 
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    City                 |    BOONSBORO
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    State                |    MD
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    Zip                  |    21713-1818
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    Country              |    US
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    Telephone            |    301-671-5040
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    23708 FOXVILLE RD 
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    City                 |    SMITHSBURG
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    State                |    MD
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    Zip                  |    21783-1913
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    Country              |    US
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    Telephone            |    240-382-4864
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    06914
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    06914
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    License Number State |    MD
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