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1043569049
RALPH BERRY
BRAINERD, MN
NPI
1043569049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303336)
Enumeration Date
2012-09-05
Last Update Date
2012-09-05
Business Address
-- RALPH BERRY LADC
15 WASHINGTON ST STE 4
BRAINERD, MN 56401-3351
Phone number: 612-454-2451
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Mailing Address
-- RALPH BERRY LADC
4633 FOREST HILLS CIR
NISSWA, MN 56468-2369
Phone number:
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