Provider Demographics
NPI:1740279728
Name:WAMPLER, MARGARET MARIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:MARIE
Last Name:WAMPLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARGIE
Other - Middle Name:
Other - Last Name:NEARY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10723 BARDSTOWN WOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-3373
Mailing Address - Country:US
Mailing Address - Phone:502-548-6274
Mailing Address - Fax:
Practice Address - Street 1:10723 BARDSTOWN WOODS BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40291-3373
Practice Address - Country:US
Practice Address - Phone:502-548-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-21
Last Update Date:2016-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY132855225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100393690Medicaid