Individual
MRS. SHELLEY LEA BERGMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.,CCC-SLP
Contact information
Practice address
6000 HOSPITAL DR, HANNIBAL, MO 63401-6887
(573) 406-5777
Mailing address
215 S MEYER RD, QUINCY, IL 62305-8018
(217) 224-2487
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
HE114933
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
469804124
—
MO
Enumeration date
11/30/2006
Last updated
11/13/2013
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