MEDICARE: MRS. MICHELLE P BERRY OTR

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
1	174400000X	Specialist	31000293A	IN
2	225X00000X	Occupational Therapist	31000293A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942498266
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE P BERRY OTR

Provider Business Mailing Address
First Line	:	6205 CONSTITUTION DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1517
Country	:	US
Telephone Number	:	260-385-2130
Fax Number	:	260-818-2044

Provider Business Practice Location Address
First Line	:	6205 CONSTITUTION DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1517
Country	:	US
Telephone Number	:	260-385-2130
Fax Number	:	260-818-2044

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	03/17/2018

Similar Medicare Providers

1689686339 — WILLIAM C. WEBER & ASSOCIATES
Practice Location Address:

6201 CONSTITUTION DR
FORT WAYNE, IN
46804-1517

Practice Phone: 260-432-0696
Practice Fax: 260-436-5795

1275647497 — MS. LINDA ANN YOUNG MS
Practice Location Address:

6201 CONSTITUTION DR
FORT WAYNE, IN
46804-1517

Practice Phone: 260-432-0696
Practice Fax: 260-436-5795

1770692865 — MR. JOHN C. HUDDLESTONE M.S., LCSW, LMFT
Practice Location Address:

6201 CONSTITUTION DR
FORT WAYNE, IN
46804-1517

Practice Phone: 260-432-0696
Practice Fax: 260-436-5795

1053420372 — MR. WILLIAM C. WEBER M.S., LCSW, CEAP
Practice Location Address:

6201 CONSTITUTION DR
FORT WAYNE, IN
46804-1517

Practice Phone: 260-432-0696
Practice Fax: 260-436-5795

1033393079 — MRS. KIMBERLY A GRIFFITH SLP
Practice Location Address:

6205 CONSTITUTION DR
FORT WAYNE, IN
46804-1517

Practice Phone: 260-438-3586
Practice Fax: 877-992-0273

1750519377 — DR. THOMAS PAUL DETTMER PSY.D
Practice Location Address:

6223 CONSTITUTION DR
FORT WAYNE, IN
46804-1517

Practice Phone: 260-755-5896
Practice Fax:

Directions to “ MRS. MICHELLE P BERRY OTR” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.