Most Relevant Information
Provider Data
| NPI Number: | 1003304270 |
| Provider Name: | KELSEY BERRYMAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/24/2018 |
| Last Updated: | 04/24/2018 |
Provider Practice Location
14301 EWING AVE S
BURNSVILLE
MN
553064885
Practice Location Phone/Fax
| Phone: | 9527465350 |
| Fax: |
Provider Mailing Location
14301 EWING AVE S
BURNSVILLE
MN
553064885
Provider Mailing Phone/Fax
| Phone: | 9527465350 |
| Fax: |