Berry, Crystal M

Berry, Crystal M is an individual health care provider with primary practice located at 612 S Irene St , San Angelo TX 76903-6629. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Berry, Crystal M can be contacted via phone (325) 658-6571.

Contact Information

Primary practice address
612 S Irene St San Angelo TX 76903-6629
Phone: (325) 658-6571
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X Texas

Profile Details

NPI number 1669777595
LBN Legal business name Berry, Crystal M
Credentials EIS-FQP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2011
Last updated Jan 25th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669777595 NPPES
Texas MEDICAID 1396867966

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