| NPI | 1285623041 |
|---|---|
| Former Name | MOLLY BERGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: CT 003986) |
| Additional Taxonomies | 231H00000X Audiologist (Licence: NY 014831) |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2020-08-18 |