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NPI Code Detail

MEDICARE: JUDY E BERRY MS

MEDICARE: JUDY E BERRY MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1265989354
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY E BERRY MS
Provider Business Mailing Address
First Line : 4856 INNOVATION DR STE B
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-5540
Country : US
Telephone Number : 970-494-4200
Fax Number :
Provider Business Practice Location Address
First Line : 1148 E ELIZABETH ST
Second Line :
City : FORT COLLINS
State : CO
Zip : 80524-4068
Country : US
Telephone Number : 970-494-4200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2016
Last Update Date : 06/03/2019

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Directions to “ JUDY E BERRY MS” Practice Location

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