Healthcare Provider Details

I. General information

NPI: 1962703785
Provider Name (Legal Business Name): KERRIE OBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2010
Last Update Date: 11/28/2025
Certification Date: 11/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W 174 GROVER CENTER
ATHENS OH
45701
US

IV. Provider business mailing address

PO BOX 600
ATHENS OH
45701-0600
US

V. Phone/Fax

Practice location:
  • Phone: 740-593-1404
  • Fax:
Mailing address:
  • Phone: 740-593-1404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP05284
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: