| NPI | 1114492956 |
|---|---|
| Former Name | MARY ELIZABETH BERGENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MS T0510) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MS T0510) |
| 171M00000X Case Manager/Care Coordinator (Licence: MS T0510) | |
| 251B00000X Case Management (Licence: MS T0510) | |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |