Individual
MRS. LISA ADDIE BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA
Contact information
Practice address
3445 POST RD, WARWICK, RI 02886-7147
(401) 739-2700
(401) 921-5493
Mailing address
163 LEDGEWOOD RD, UNIT 203, GROTON, CT 06340-6611
(401) 451-4863
(401) 921-5493
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0-11-4097
RI
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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