| NPI | 1487025862 |
|---|---|
| Other Name | AMANDA J BERGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: IL 180009982) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: IL 178009847) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2018-03-17 |