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Contact Information

BLAKE N BERRY
3714 E CAMPUS DR STE 101
EAGLE MOUNTAIN, UT84005-5451
 Phone: 801-789-7780
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for BLAKE N BERRY · (Male)

NPI Number 1548537772
Status Active
Credentials
Entity Individual
Enumeration date 11/16/2011
Last updated 05/20/2026 - About 2 weeks ago
Sole proprietor 1 No
Identifiers
  • UT License # 12110885-3502
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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