| NPI | 1598988081 |
|---|---|
| Other Name | JACK HUDSON BERKLEY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: WV 728) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 03431) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |