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Individual
JILL BERGEN
Active
Individual
JILL BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6851-125
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
16240-132
WI
101YM0800X
Mental Health Counselor
6851-125
WI
Other
Enumeration date
06/09/2016
Last updated
11/12/2024
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