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Individual

CORNELOUS H BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
510 E BURLEIGH ST, MILWAUKEE, WI 53212-2119
(180) 043-8177
(262) 345-5562
Mailing address
W175N11120 STONEWOOD DR, GERMANTOWN, WI 53022-4799
(800) 438-1772
(262) 293-3797

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
WI

Other

Enumeration date
12/14/2021
Last updated
12/14/2021
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