Doctor Name: | DEVON BERRY |
NPI Number: | 1851715064 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | AAS.HUS |
License Number: | |
Business Practice Address: | 1390 Old Indian Mills Road Shamong Road Group Home Shamong, NJ - 08088 |
Business Phone Number: | 6092675928 |
Business Fax Number: | |
Mailing Address: | 770 Woodlane Rd, WESTAMPTON |
State: | NJ |
Postal Code: | 080603804 |
Phone Number: | 6092675928 |
Fax Number: | |
NPI Enumeration Date: | 02/07/2014 |
NPI Last Update Date: | 02/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |