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Organization
BERRY SPEECH AND LANGUAGE PATHOLOGY, PROFESSIONAL CORPORATION
Active
Organization
BERRY SPEECH AND LANGUAGE PATHOLOGY, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN BLAKE BERRY MS, CCC-SLP (OWNER)
(619) 468-4609
Entity
Organization
Contact information
Practice address
4455 CAMPUS AVE, SAN DIEGO, CA 92116-3905
(619) 468-4609
Mailing address
4455 CAMPUS AVE, SAN DIEGO, CA 92116-3905
(619) 468-4609
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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