| NPI | 1093159691 |
|---|---|
| Former Name | MARY KATHRYN BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5574-125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 1640-226) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2015-03-18 |