Provider Demographics
NPI:1336371541
Name:BERRY, ANDREA A (MHR)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:A
Last Name:BERRY
Suffix:
Gender:F
Credentials:MHR
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Mailing Address - Street 1:920 E SHERIDAN ST, SUITE B
Mailing Address - Street 2:WYOMING ART THERAPY AND MEDICAL COUNSELING
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82070-3868
Mailing Address - Country:US
Mailing Address - Phone:307-760-6125
Mailing Address - Fax:307-460-3846
Practice Address - Street 1:920 E SHERIDAN ST APT B
Practice Address - Street 2:WYOMING ART THERAPY & MEDICAL COUNSELING LLC.
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3868
Practice Address - Country:US
Practice Address - Phone:307-760-6125
Practice Address - Fax:307-460-3767
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2013-12-06
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Provider Licenses
StateLicense IDTaxonomies
WYLPC-1049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional