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Individual

BILLY LEE BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MARRIAGE FAMILY THER

Contact information

Practice address
332 3RD AVE, JASPER, IN 47546
(812) 634-9408
(812) 482-6712
Mailing address
332 3RD AVE, JASPER, IN 47546
(812) 634-9408
(812) 482-6712

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
106H00000X
Marriage & Family Therapist
33003623A
IN

Other

Enumeration date
03/26/2007
Last updated
10/28/2010
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