Individual
FARD ALI BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
399 REVOLUTION DR, SOMERVILLE, MA 02145-1484
(857) 523-9279
Mailing address
123 RESERVOIR AVE, REVERE, MA 02151-5825
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCSW228777
MA
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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