| NPI | 1588211874 |
|---|---|
| Former Name | NICOLE MARIE BERGAMO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301019415) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301019415) |
| 103T00000X Psychologist (Licence: MI 6362001372) | |
| 103T00000X Psychologist (Licence: MI 6351004559) | |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2024-10-09 |