| NPI | 1760810493 |
|---|---|
| Former Name | STEPHANIE BERGMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 2013018075) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2023-03-29 |