Individual
MRS. ANNALISA K BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
502 W RANDOLPH AVE, ENID, OK 73701-3828
(580) 234-8000
Mailing address
502 W RANDOLPH AVE, ENID, OK 73701-3828
(580) 234-8000
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/29/2010
Last updated
03/29/2010
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