Provider Demographics
NPI:1871888651
Name:BERRY, DAYNA LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:LYNN
Last Name:BERRY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:DAYNA
Other - Middle Name:
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1013 CHANCELLOR DR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3905
Mailing Address - Country:US
Mailing Address - Phone:618-334-1868
Mailing Address - Fax:
Practice Address - Street 1:1013 CHANCELLOR DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3905
Practice Address - Country:US
Practice Address - Phone:618-334-1868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist