Organization Name: | BERRY SPEECH THERAPY |
NPI Number: | 1770926719 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MAGGIE BERRY (SPEECH-LANGUAGE PATHOLOGIST) |
Mailing Address: | 811 Copperfield Dr Rapid City |
State: | SD US |
Postal Code: | 577034736 |
Phone Number: | 6054842303 |
Fax Number: | |
NPI Enumeration Date: | 04/09/2013 |
NPI Last Update Date: | 04/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12119970 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SD |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |