Individual
LISA LOIUSE BERRY
Active
Individual
LISA LOIUSE BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
106730
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THW000106730
—
OR
Enumeration date
08/23/2022
Last updated
12/27/2022
Update your record
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