Provider Demographics
NPI:1861896748
Name:KERBER, EMILY CHRISTINE (MS, CFY-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CHRISTINE
Last Name:KERBER
Suffix:
Gender:F
Credentials:MS, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 VINE ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-1768
Mailing Address - Country:US
Mailing Address - Phone:507-402-2553
Mailing Address - Fax:
Practice Address - Street 1:2495 MAPLEWOOD DR
Practice Address - Street 2:STE 313
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-1984
Practice Address - Country:US
Practice Address - Phone:651-770-8884
Practice Address - Fax:651-770-8151
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9295235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist