Provider Demographics
NPI:1932434008
Name:BERRY, SHELLEY LYNN (RRT)
Entity Type:Individual
Prefix:MS
First Name:SHELLEY
Middle Name:LYNN
Last Name:BERRY
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 CLARA DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:OH
Mailing Address - Zip Code:45067-1181
Mailing Address - Country:US
Mailing Address - Phone:513-465-6448
Mailing Address - Fax:937-790-4051
Practice Address - Street 1:725 CLARA DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:OH
Practice Address - Zip Code:45067-1181
Practice Address - Country:US
Practice Address - Phone:513-465-6448
Practice Address - Fax:937-790-4051
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279H0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredHome Health