Individual
KAITLYN BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 933-4204
Mailing address
1443 JOHNS CT, OXFORD, MI 48371-5935
(248) 933-4204
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010389
MI
Other
Enumeration date
05/06/2020
Last updated
11/29/2021
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