Individual
MARTHA PHOENIX BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,LPC
Contact information
Practice address
31365 COACHLIGHT LN, BINGHAM FARMS, MI 48025-4403
(248) 646-3969
Mailing address
31365 COACHLIGHT LN, BINGHAM FARMS, MI 48025-4403
(248) 646-3969
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2684
NC
101YP2500X
Professional Counselor
Primary
6401007192
MI
Other
Enumeration date
06/14/2008
Last updated
06/14/2008
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