Individual
LARSEN K BERGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
113 TREMONT ST, DUXBURY, MA 02332-4753
(781) 934-6226
Mailing address
113 TREMONT ST, DUXBURY, MA 02332-4753
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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