Provider Demographics
NPI:1437303096
Name:KOBER, MARIA ANTONIA (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANTONIA
Last Name:KOBER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157-12 12TH AVE.
Mailing Address - Street 2:
Mailing Address - City:BEECHHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11357
Mailing Address - Country:US
Mailing Address - Phone:718-746-1496
Mailing Address - Fax:718-746-5090
Practice Address - Street 1:15712 12TH AVE
Practice Address - Street 2:
Practice Address - City:BEECHHURST
Practice Address - State:NY
Practice Address - Zip Code:11357-1941
Practice Address - Country:US
Practice Address - Phone:718-746-1496
Practice Address - Fax:718-746-5090
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006374-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist