Provider Demographics
NPI:1285449884
Name:BERRY, LAUREN (MT-BC)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:BERRY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 W UNIVERSITY DR STE 108
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-3281
Mailing Address - Country:US
Mailing Address - Phone:602-960-2200
Mailing Address - Fax:
Practice Address - Street 1:1555 W UNIVERSITY DR STE 108
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-3281
Practice Address - Country:US
Practice Address - Phone:602-960-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19309225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist