Provider Demographics
NPI:1124889795
Name:BERRY, CHRISTINE M (BCHHP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:BERRY
Suffix:
Gender:F
Credentials:BCHHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11308 JUNE BRIAR LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:FL
Mailing Address - Zip Code:33576-8190
Mailing Address - Country:US
Mailing Address - Phone:813-503-2419
Mailing Address - Fax:
Practice Address - Street 1:11308 JUNE BRIAR LOOP
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:FL
Practice Address - Zip Code:33576-8190
Practice Address - Country:US
Practice Address - Phone:813-503-2419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach