PENELOPE BERGERON

PROVO, UT
NPI1457719924
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: UT  7005879-3501)
Enumeration Date2016-01-29
Last Update Date2016-01-29
Business Address
Mrs. PENELOPE BERGERON LCSW
315 S 100 E
PROVO, UT 84606-4649
Phone number: 801-318-7037
Mailing Address
Mrs. PENELOPE BERGERON LCSW
5612 W 10930 N
HIGHLAND, UT 84003-8897
Phone number: 801-318-7037