Organization
JENNIFER BERGMAN MS CCC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER BERGMAN MS (PRESIDENT)
(856) 983-6160
Entity
Organization
Contact information
Practice address
475 OLD MARLTON PIKE W, SUITE 1, MARLTON, NJ 08053-2098
(856) 983-6160
Mailing address
475 OLD MARLTON PIKE W, SUITE 1, MARLTON, NJ 08053-2098
(856) 983-6160
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00090300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41YS00090300
LICENSE
NJ
Enumeration date
05/30/2007
Last updated
08/22/2020
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