Individual
STEPHANIE P BERGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD CD
Contact information
Practice address
1132 E BRYAN AVE APT A, SALT LAKE CITY, UT 84105-2508
(802) 310-0068
Mailing address
1132 E BRYAN AVE APT A, SALT LAKE CITY, UT 84105-2508
(802) 310-0068
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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