Individual
DIANE L BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8305 SE MONTEREY, #220, PORTLAND, OR 97266
(503) 650-4359
(503) 650-6913
Mailing address
PO BOX 249, GLADSTONE, OR 97027
(503) 650-4359
(503) 650-6913
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2067
OR
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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