Individual
PAUL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC
Contact information
Practice address
4567 CROSSROADS PARK DR, LIVERPOOL, NY 13088-3589
(315) 883-1602
Mailing address
4567 CROSSROADS PARK DR, LIVERPOOL, NY 13088-3589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
36244
NY
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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