Provider Demographics
NPI:1851559181
Name:RUPP, ALLISON (OTR/L)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:RUPP
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 1:4 FOX RUN
Mailing Address - Street 2:
Mailing Address - City:CALIFON
Mailing Address - State:NJ
Mailing Address - Zip Code:07830-3334
Mailing Address - Country:US
Mailing Address - Phone:617-548-1780
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:SUITE H3124
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-723-6701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9436225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist