# MRS. STEPHANIE KROK BERRY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1063499648
- **Gender:** F
- **Credential:** P.T.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 001143 | CT | Yes |

## Other

- **Enumeration date:** 12/27/2005
- **Last updated:** 11/21/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 042751 | HEALTHNET | — |
| 01 | — | 080001143CT03 | ANTHEM BLUE CROSS & BLUE | CT |
| 01 | — | 221657 | WELLCARE | — |
| 01 | — | Q30Y4 | EMPIRE BLUE CROSS BLUE SH | — |