Individual
JENSEN J. BERGERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A. L.P.C.
Contact information
Practice address
600 JEFFERSON STREET SUITE 903, LAFAYETTE, LA 70501
(337) 706-5105
Mailing address
217 TREAT DRIVE, BROUSSARD, LA 70518
(337) 706-5105
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4618
LA
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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