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Individual

DR. RAYMOND MICHAEL BERGNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
901 E GROVE ST, BLOOMINGTON, IL 61701-4200
(309) 828-6821
Mailing address
901 E GROVE ST, BLOOMINGTON, IL 61701-4200
(309) 828-6821

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
IL

Other

Enumeration date
01/03/2008
Last updated
01/03/2008
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