Individual
SHARON LEE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP, ABPP
Contact information
Practice address
BERRY PSYCHOLOGICAL SERVICES, 3340 REPUBLIC AVENUE, SUITE 120, ST. LOUIS PARK, MN 55426-4154
(612) 916-5605
(612) 813-8263
Mailing address
2817 WEBSTER AVENUE SOUTH, ST. LOUIS PARK, MN 55416-1845
(612) 916-5605
(651) 855-2310
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
MN3625
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP3625
MN
103TC2200X
Clinical Child & Adolescent Psychologist
MN3625
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339214700
—
MN
Enumeration date
09/13/2005
Last updated
10/15/2021
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