Organization
DOUGLAS A. BERGSTROM, PH.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS ALAN BERGSTROM PH.D. (PSYCHOLOGIST)
(928) 445-3835
Entity
Organization
Contact information
Practice address
143 E MERRITT ST, PRESCOTT, AZ 86301-2028
(928) 445-3835
(928) 445-7071
Mailing address
143 E MERRITT ST, PRESCOTT, AZ 86301-2028
(928) 445-3835
(928) 445-7071
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1142
AZ
Other
Enumeration date
11/13/2007
Last updated
11/13/2007
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