Provider Demographics
NPI:1053571448
Name:EISEMAN, MOLLY OSHEA (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:OSHEA
Last Name:EISEMAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 GRAND AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4500
Mailing Address - Country:US
Mailing Address - Phone:415-699-1573
Mailing Address - Fax:303-702-0108
Practice Address - Street 1:240 GRAND AVE APT 24
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4500
Practice Address - Country:US
Practice Address - Phone:415-699-1573
Practice Address - Fax:303-702-0108
Is Sole Proprietor?:No
Enumeration Date:2008-06-10
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist