Individual
TABITHA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
645 W 6TH ST, AXTELL, NE 68924-3401
(602) 469-3257
Mailing address
1719 S LOCUST ST, GRAND ISLAND, NE 68801-8248
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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