Individual
DR. AUDREY MARILYN BERGER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1606
(585) 292-0095
(585) 424-7592
Mailing address
300 WHITE SPRUCE BLVD, ROCHESTER, NY 14623-1606
(585) 292-0095
(585) 424-7592
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
007207-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007207
NYS LICENSE
NY
01
—
103225FC
PREFERRED CARE PROVIDERID
NY
Enumeration date
03/16/2006
Last updated
07/08/2007
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