Individual
KIMBERLY MICHELLE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
20510 SW ROY ROGERS RD UNIT 210, SHERWOOD, OR 97140-9320
(360) 771-7538
Mailing address
20510 SW ROY ROGERS RD UNIT 210, SHERWOOD, OR 97140-9320
(360) 771-7538
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
Primary
RBT--19-77656
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ABA-IN-10203849
OREGON HEALTH LICENSING
OR
01
—
RBT-19-77656
BACB
—
Enumeration date
02/20/2019
Last updated
01/02/2023
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