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1760134910
KEVIN JAY BERGSTROM
NORTH PLATTE, NE
NPI
1760134910
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: NE 12870)
Enumeration Date
2022-01-19
Last Update Date
2022-01-19
Business Address
KEVIN JAY BERGSTROM
1221 W 17TH ST
NORTH PLATTE, NE 69101-2216
Phone number: 308-380-9196
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Mailing Address
KEVIN JAY BERGSTROM
6459 S HOMESTEAD RD
NORTH PLATTE, NE 69101-6979
Phone number: 308-380-9196
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