Individual
DIANE M BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2215 WASHINGTON ST, MANITOWOC, WI 54220-4847
(920) 683-3911
(920) 683-3911
Mailing address
2215 WASHINGTON ST, MANITOWOC, WI 54220-4847
(920) 683-3911
(920) 683-3911
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6531123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39759100
—
WI
Enumeration date
07/31/2006
Last updated
10/25/2011
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