Individual
ALTHEA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1905 S TOPAZ WAY STE 100, MERIDIAN, ID 83642-4477
(208) 518-0870
Mailing address
8743 W PINE VALLEY LN, BOISE, ID 83709-0020
(715) 853-2884
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79155
ID
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
1-25-79155
ID
Other
Enumeration date
04/09/2022
Last updated
01/22/2026
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