Individual
KATIE BREANN BERGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
992 NORTHPARK DR, RIDGELAND, MS 39157-5193
(318) 498-2760
Mailing address
4 COUNTY ROAD 2315, LAUREL, MS 39443-8113
(318) 498-2760
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-79628
MS
103K00000X
Behavior Analyst
BH007959
PA
103K00000X
Behavior Analyst
LABA10001900
MA
Other
Enumeration date
03/10/2025
Last updated
03/11/2026
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