Berry, Michelle P
Berry, Michelle P is an sole proprietor health care provider with primary practice located at 6205 Constitution Dr , Fort Wayne IN 46804-1517. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Berry, Michelle P can be contacted via phone (260) 385-2130.Contact Information
Primary practice address
6205 Constitution Dr
Fort Wayne IN 46804-1517
Phone: (260) 385-2130
Fax: (260) 818-2044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 31000293A | Indiana |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist | 225X00000X | 31000293A | Indiana |
Profile Details
| NPI number | 1942498266 |
|---|---|
| LBN Legal business name | Berry, Michelle P |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2007 |
| Last updated | Mar 17th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942498266 | NPPES |
| Indiana | MEDICAID | 200628720A |
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