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General NPI Number Information
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NPI Number | 1427782143
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Entity Type | Organization
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Legal Business Name | BERRY'S EXCLUSIVE SERVICE FOR THERAPY SOLUTIONS, LLC
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 2332 WINDY PINES BND
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-3963
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Country | US
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Telephone | 757-667-9410
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Fax |
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Provider Business Mailing Address
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Address Line | 2332 WINDY PINES BND
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City | VIRGINIA BEACH
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State | VA
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Zip | 23456-3963
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. STEPHANIE CHARNICE BERRY
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Credential | MA, CCC- SLP
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Telephone | 757-667-9410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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