Provider Demographics
NPI:1326222498
Name:BERRY, JESSICA MARIA (DPT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIA
Last Name:BERRY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:14287 N 87TH ST STE 220
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3698
Mailing Address - Country:US
Mailing Address - Phone:602-329-8250
Mailing Address - Fax:480-565-1898
Practice Address - Street 1:5215 W BASELINE RD STE 101
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-2943
Practice Address - Country:US
Practice Address - Phone:623-219-4600
Practice Address - Fax:623-219-4601
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2022-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ7147225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist