Individual
MIRANDA BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 BEN RD APT 7, SAINT ALBANS, WV 25177-3900
(304) 769-8077
Mailing address
1050 BEN RD APT 7, SAINT ALBANS, WV 25177-3900
(304) 769-8077
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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