Provider Demographics
NPI:1043539786
Name:O'BERSKI, EMILY VIRGINIA
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:VIRGINIA
Last Name:O'BERSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 11TH ST NW
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-5068
Mailing Address - Country:US
Mailing Address - Phone:563-241-4230
Mailing Address - Fax:563-241-4233
Practice Address - Street 1:1377 11TH ST NW
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5068
Practice Address - Country:US
Practice Address - Phone:563-241-4230
Practice Address - Fax:563-241-4233
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001958235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist