Individual
MISS MICHELLE L OBERMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP/L
Contact information
Practice address
801 N 11TH ST, MEDICAID DEPARTMENT, SAINT LOUIS, MO 63101-1015
(314) 345-2535
Mailing address
6365 MEADOWLAKE DR, WASHINGTON, MO 63090-4131
(314) 402-8499
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2008020882
MO
Other
Enumeration date
12/31/2008
Last updated
12/31/2008
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