Provider Demographics
NPI:1588917595
Name:RUPERT, AMBER FAYE (MS, OTR/L, CKTP, CDP)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:FAYE
Last Name:RUPERT
Suffix:
Gender:F
Credentials:MS, OTR/L, CKTP, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23708 FOXVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21783-1913
Mailing Address - Country:US
Mailing Address - Phone:240-382-4864
Mailing Address - Fax:
Practice Address - Street 1:8507 MAPLEVILLE RD
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1818
Practice Address - Country:US
Practice Address - Phone:301-671-5040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06914225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics