Individual
LISA BETH BERGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1441 S LINDSAY RD APT 1042, MESA, AZ 85204-6288
(860) 478-4533
Mailing address
1441 S LINDSAY RD APT 1042, MESA, AZ 85204-6288
(860) 478-4533
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6495
AZ
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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