Individual
TAMMY LEE BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 US OVAL STE 100, PLATTSBURGH, NY 12903-5901
(518) 578-1442
Mailing address
22 US OVAL STE 100, PLATTSBURGH, NY 12903-5901
(518) 578-1442
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
P13611
NY
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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