Individual
GREGORIE SHAMUS BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
5513 110TH AVE APT F304, PINELLAS PARK, FL 33782-9117
(727) 831-0627
Mailing address
5513 110TH AVE APT F304, PINELLAS PARK, FL 33782-9117
(727) 831-0627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10670
FL
Other
Enumeration date
01/21/2009
Last updated
01/21/2009
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