Individual provider · NPI-1

Grover Berry III, AA Management

Clinical Neuropsychologist · Las Vegas, NV

NPI number1578971065
StatusActive
Last updated in NPPESJul 28, 2014

Details

NPI
1578971065
Entity type
Individual (NPI-1)
Name
Grover Berry III
Credential
AA Management
Sex
Male
Sole proprietor
Yes
Enumeration date
Jul 28, 2014
Last updated
Jul 28, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103G00000X Clinical Neuropsychologist–NVYes

Practice location

3660 N Rancho Dr Ste 113
Las Vegas, NV 89130-3188

Phone 702-982-2928

Mailing address

3360 N Rancho Dr. Ste.113
Las Vegas, NV 89130

Phone 702-982-2928

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