Provider Demographics
NPI:1407051915
Name:OVREBO, EMILY KAY (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KAY
Last Name:OVREBO
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-3619
Mailing Address - Country:US
Mailing Address - Phone:507-235-6070
Mailing Address - Fax:
Practice Address - Street 1:1420 N STATE ST
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-3619
Practice Address - Country:US
Practice Address - Phone:507-235-6070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5317103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical