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DR. ENNIS BERKER PH.D.

Clinical Neuropsychologist

Dexter, Michigan

Provider NPI: 1316039357

Provider Information:
DR. ENNIS  BERKER PH.D.
Gender: M
Sole Proprietor


Practice Location:
1008 MERLIN WAY  DEXTER, MI 48130 US
Tel: 269-217-2992  Fax: 734-623-0108

Business Mailing Address:
1008 MERLIN WAY  DEXTER, MI 48130 US
Tel: 269-217-2992  Fax: 734-623-0108

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MI6301 006050
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MI6301006050

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSSC 94573MI01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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