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NPI Code Detail

MEDICARE: N'DEA BERRY

MEDICARE: N'DEA BERRY
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
1103K00000XBehavior Analyst7401002841MI

General Provider Information

NPI Number : 1811500853
Entity Type Code : Individual
Provider Name (Legal Business Name) : N'DEA BERRY
Provider Business Mailing Address
First Line : 39453 FORD RD
Second Line :
City : CANTON
State : MI
Zip : 48187-4320
Country : US
Telephone Number : 248-277-3005
Fax Number :
Provider Business Practice Location Address
First Line : 39453 FORD RD
Second Line :
City : CANTON
State : MI
Zip : 48187-4320
Country : US
Telephone Number : 248-277-3005
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 06/11/2025

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Directions to “ N'DEA BERRY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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