Individual
AUDREY R BERGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
5006 COPPER NE, ALBUQUERQUE, NM 87108
(505) 268-7988
(505) 268-8021
Mailing address
6204 EAGLE EYE NW, ALBUQUERQUE, NM 87120
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1662
NM
Other
Enumeration date
01/23/2006
Last updated
09/14/2011
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