Individual
DANIEL BERGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 S. WALNUT ST., APPLETON, WI 54911-5918
(920) 832-5270
Mailing address
320 S. WALNUT ST., APPLETON, WI 54911-5918
(920) 832-5270
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3113-226
WI
101YM0800X
Mental Health Counselor
3113226
WI
101YP2500X
Professional Counselor
Primary
6755
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100064881
—
WI
Enumeration date
02/24/2017
Last updated
03/17/2020
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