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Individual

KELLY BERTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1710 DOUGLAS DR N STE 224K, GOLDEN VALLEY, MN 55422-4359
(920) 483-0450
(612) 473-3201
Mailing address
3305 CEDAR AVE S, MINNEAPOLIS, MN 55407-2355

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
07/02/2019
Last updated
02/13/2024
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