| NPI | 1639477532 |
|---|---|
| Former Name | MARJORIE LORRAINE BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 115397) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 33331) |
| 1041C0700X Social Worker, Clinical (Licence: 93781) | |
| Enumeration Date | 2011-03-02 |
| Last Update Date | 2024-10-02 |