Healthcare Provider Details

I. General information

NPI: 1255264008
Provider Name (Legal Business Name): MRS. ANNE OBERMILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 CEDAR LAKE RD
MINNETONKA MN
55305-3361
US

IV. Provider business mailing address

1001 HIGHWAY 7
HOPKINS MN
55305-4737
US

V. Phone/Fax

Practice location:
  • Phone: 952-988-4800
  • Fax: 952-988-4869
Mailing address:
  • Phone: 952-988-4000
  • Fax: 952-988-4092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number455042
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: