Individual
KRISTEN I BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
48 GILMAN ST, PORTLAND, ME 04102-3004
(207) 662-2759
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2759
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC12191
ME
Other
Enumeration date
09/02/2010
Last updated
11/26/2014
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