Individual
KELLY MICHELE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP, M.S.
Contact information
Practice address
75 W COMMERCIAL ST, 205, PORTLAND, ME 04101-4797
(207) 874-1065
Mailing address
75 W COMMERCIAL ST, 205, PORTLAND, ME 04101-4797
(207) 874-1065
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
ST2438
ME
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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