Provider Information for 1063811362
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NATALIE R. L BERRYMAN MS, LPC
Sex: Female
NPI: 1063811362
Last Updated: 2025-03-25
Certification Date: 2025-03-25
Certification Date: 2025-03-25
Details
Name | Value | ||||||||
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NPI | 1063811362 | ||||||||
Enumeration Date | 2014-08-22 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 5238 64TH AVE APT 16 KENOSHA, WI 53144-3745 United States Phone: 918-388-7380 | Fax: | ||||||||
Primary Practice Address | 6809 122ND AVE KENOSHA, WI 53142-7335 United States Phone: 262-891-6575 | Fax:262-654-5467 | ||||||||
Secondary Practice Address(es) | 1143 WARWICK WAY UNIT A | ||||||||
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