Individual
JERMAINE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2314 KENWORTHY DR, MISSOURI CITY, TX 77459-2104
(832) 997-8854
Mailing address
2314 KENWORTHY DR, MISSOURI CITY, TX 77459-2104
(503) 819-0839
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01262018
COUNCELOR
TX
05
—
09072018
—
TX
Enumeration date
10/01/2020
Last updated
10/01/2020
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