Provider Demographics
NPI:1821041120
Name:OBERT, PAMELA A (CCCA)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:A
Last Name:OBERT
Suffix:
Gender:F
Credentials:CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4124
Mailing Address - Country:US
Mailing Address - Phone:413-447-2225
Mailing Address - Fax:413-346-6798
Practice Address - Street 1:510 NORTH STREET
Practice Address - Street 2:SUITE 6 ROOM 202
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4117
Practice Address - Country:US
Practice Address - Phone:413-447-2225
Practice Address - Fax:413-346-6798
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAD0048OtherBC/BS OF MASSACHUSETTS
MAAD0048OtherBC/BS OF MASSACHUSETTS