Individual
DEBRA BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 280-2700
Mailing address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1980
WI
1041C0700X
Clinical Social Worker
Primary
2616
WI
164W00000X
Licensed Practical Nurse
24505
WI
Other
Enumeration date
05/17/2007
Last updated
09/11/2007
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