Individual
LAURA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
11370 N STATE ROAD 67, MOORESVILLE, IN 46158-6368
(812) 339-1691
(812) 378-8367
Mailing address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(812) 339-1691
(812) 378-8367
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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