Individual
ANDREA R BERGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1154 PARADISE SAFARI DR, HENDERSON, NV 89002-8935
(702) 743-0980
Mailing address
4760 S PECOS RD, LAS VEGAS, NV 89121-6038
(702) 601-2697
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NV
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/02/2011
Last updated
10/09/2019
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