NPI | 1972650141 |
---|---|
Former Name | STEPHEN C. BERRY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 6229) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OH 4586) |
Enumeration Date | 2007-01-03 |
Last Update Date | 2007-07-08 |