| NPI | 1225872120 |
|---|---|
| Former Name | ALICIA FAYE BERGERON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 90377) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 903777) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-07-17 |