Individual
JODY L BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5270
(920) 832-4767
Mailing address
320 S WALNUT ST, APPLETON, WI 54911-5918
(920) 832-5270
(920) 832-4767
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7810
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100099066
—
WI
Enumeration date
04/30/2020
Last updated
03/24/2022
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