Provider Demographics
NPI:1619360047
Name:BERI, REEMA S (PHD)
Entity Type:Individual
Prefix:DR
First Name:REEMA
Middle Name:S
Last Name:BERI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49410 WATERSTONE ESTATES CIR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4900
Mailing Address - Country:US
Mailing Address - Phone:248-719-4056
Mailing Address - Fax:
Practice Address - Street 1:21800 HAGGERTY RD STE 207
Practice Address - Street 2:
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-8981
Practice Address - Country:US
Practice Address - Phone:248-719-4056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL549334103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical