| Doctor Name: | STEPHANIE LYNN OBERT |
| NPI Number: | 1265822837 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CF- SLP |
| License Number: | TSLP2686 |
| Business Practice Address: | 320 11th Ave S Suite 204 Nampa, ID - 836515073 |
| Business Phone Number: | 2084661077 |
| Business Fax Number: | 2084672201 |
| Mailing Address: | 1317 W State St, Apt 4 BOISE |
| State: | ID |
| Postal Code: | 837025054 |
| Phone Number: | 2074313211 |
| Fax Number: | |
| NPI Enumeration Date: | 02/03/2015 |
| NPI Last Update Date: | 02/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | TSLP2686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |