Organization
BRENDA L. BERGMAN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA BERGMAN PH.D. (PRESIDENT)
(218) 740-3060
Entity
Organization
Contact information
Practice address
306 W SUPERIOR ST, SUITE 608, DULUTH, MN 55802-1803
(218) 740-3060
(218) 740-3060
Mailing address
306 W SUPERIOR ST, SUITE 608, DULUTH, MN 55802-1803
(218) 740-3060
(218) 740-3060
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1730
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117597
HEALTHPARTNERS
MN
01
—
358J1BE
BLUE CROSS
MN
01
—
61-24268
UBH
MN
05
—
806547100
—
MN
Enumeration date
08/10/2006
Last updated
07/14/2011
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