Individual
JARVIS DWAYNE BERRY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6150 W CHEERY LYNN RD, PHOENIX, AZ 85033-5833
(623) 440-8989
Mailing address
PO BOX 6751, GOODYEAR, AZ 85338-0630
(623) 440-8989
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH5698
AZ
Other
Enumeration date
02/06/2020
Last updated
12/21/2020
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