Provider Demographics
NPI:1912040882
Name:BERRY, TERESA MONTEITH (GENETIC COUNSELOR)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MONTEITH
Last Name:BERRY
Suffix:
Gender:F
Credentials:GENETIC COUNSELOR
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:AMY
Other - Last Name:MONTEITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GENETIC COUNSELOR
Mailing Address - Street 1:114 WOODLAND ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-1299
Mailing Address - Country:US
Mailing Address - Phone:860-714-5062
Mailing Address - Fax:860-714-8073
Practice Address - Street 1:114 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-1299
Practice Address - Country:US
Practice Address - Phone:860-714-5062
Practice Address - Fax:860-714-8073
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS