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General NPI Number Information
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NPI Number | 1588770572
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Entity Type | Individual
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Provider Name | ROBERT A BERRY PHD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 2860 HOPI DRVE, SUITE 2B
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City | SEDONA
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State | AZ
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Zip | 86336
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Country | US
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Telephone | 312-719-6789
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Fax | 928-554-4166
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Provider Business Mailing Address
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Address Line | PO BOX 4265
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City | SEDONA
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State | AZ
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Zip | 86340-4265
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Country | US
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Telephone | 312-719-6789
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Fax | 928-554-4166
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071003335
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1987
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License Number State | AZ
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