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1497856637
SUSAN DIANE BERGEN
TWIN FALLS, ID
NPI
1497856637
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: ID LMFT-2962)
Enumeration Date
2006-09-26
Last Update Date
2007-07-08
Business Address
SUSAN DIANE BERGEN MA, LMFT
647 FILER AVE
TWIN FALLS, ID 83301-4008
Phone number: 208-737-9999
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Mailing Address
SUSAN DIANE BERGEN MA, LMFT
225 LONG ISLAND AVE
TWIN FALLS, ID 83301-3096
Phone number: 208-735-1561
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