Individual
DR. LAURIE L. BERGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
901 E GROVE ST, BLOOMINGTON, IL 61701-4200
(309) 828-6821
Mailing address
502 S BLAIR DR, NORMAL, IL 61761-3110
(309) 454-3113
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
IL
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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