Provider Demographics
NPI:1780842757
Name:BERRY, JANETTE MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:JANETTE
Middle Name:MARIE
Last Name:BERRY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4140 E BASELINE RD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-4412
Mailing Address - Country:US
Mailing Address - Phone:480-539-4000
Mailing Address - Fax:480-497-7866
Practice Address - Street 1:4140 E BASELINE RD
Practice Address - Street 2:SUITE 211
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-4412
Practice Address - Country:US
Practice Address - Phone:480-539-4000
Practice Address - Fax:480-497-7866
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1507237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter