Organization
BERRY SPEECH AND LANGUAGE PATHOLOGY, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN BLAKE BERRY MS, CCC-SLP (OWNER)
(619) 468-4609
Entity
Organization
Contact information
Practice address
4455 CAMPUS AVE, SAN DIEGO, CA 92116-3905
(619) 468-4609
Mailing address
4455 CAMPUS AVE, SAN DIEGO, CA 92116-3905
(619) 468-4609
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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