Individual
CONSTANCE M BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD, CCC-A
Contact information
Practice address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Mailing address
280 EXEMPLA CIR, LAFAYETTE, CO 80026-3370
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
292
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07487101
—
CO
01
—
17356
KAISER COMMERCIAL NUMBER
CO
Enumeration date
03/07/2007
Last updated
01/18/2013
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