Provider Demographics
NPI:1538513809
Name:BERRY, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 EDWARDS ALY
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:16666-1011
Mailing Address - Country:US
Mailing Address - Phone:215-208-6583
Mailing Address - Fax:
Practice Address - Street 1:805 EDWARDS ALY
Practice Address - Street 2:
Practice Address - City:OSCEOLA MILLS
Practice Address - State:PA
Practice Address - Zip Code:16666-1011
Practice Address - Country:US
Practice Address - Phone:215-208-6583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist