Individual
AMANDA BERGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6280 E PIMA ST, TUCSON, AZ 85712-3074
(520) 329-1250
Mailing address
2733 N NORRIS AVE, TUCSON, AZ 85719-3232
(520) 360-9670
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-17391
AZ
Other
Enumeration date
10/02/2018
Last updated
10/02/2018
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