Provider Demographics
NPI:1447970686
Name:CLARA A BERRY SLP LLC
Entity type:Organization
Organization Name:CLARA A BERRY SLP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:ADELAIDE
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC SLP
Authorized Official - Phone:802-380-1564
Mailing Address - Street 1:40 KIMBALL BEACH RD
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1146
Mailing Address - Country:US
Mailing Address - Phone:802-380-1564
Mailing Address - Fax:
Practice Address - Street 1:40 KIMBALL BEACH RD
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1146
Practice Address - Country:US
Practice Address - Phone:802-380-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty