Most Relevant Information
Provider Data
NPI Number: | 1003423187 |
Provider Name: | KACEY ALLISON BERBERICH |
Entity Type: | Individual |
Taxonomy Code: | 106S00000X |
Specialty: | Behavior Technician |
License Number: |
Most Important Dates
Enumeration Date: | 09/23/2020 |
Last Updated: | 02/22/2022 |
Provider Practice Location
12901 SE 97TH AVE STE 340
CLACKAMAS
OR
970157903
Practice Location Phone/Fax
Phone: | 5036558045 |
Fax: | 5036556806 |
Provider Mailing Location
528 W J ST
BENICIA
CA
945103045
Provider Mailing Phone/Fax
Phone: | 9252865458 |
Fax: |