Individual
JESSE BERGENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S CCC-SLP
Contact information
Practice address
112 BROWN PERCH DR, LEXINGTON, SC 29072-2484
(917) 837-8268
Mailing address
112 BROWN PERCH DR, LEXINGTON, SC 29072-2484
(917) 837-8268
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
021775
NY
235Z00000X
Speech-Language Pathologist
Primary
8071
SC
Other
Enumeration date
01/22/2015
Last updated
03/31/2026
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