Individual
MR. DANIEL PAUL BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., L.P.C., N.C.C
Contact information
Practice address
1247 RALEIGH ST, GREEN BAY, WI 54304-3848
(920) 497-0846
Mailing address
1247 RALEIGH ST, GREEN BAY, WI 54304-3848
(920) 497-0846
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3484-125
WI
101YP2500X
Professional Counselor
Primary
3484-125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40979800
—
WI
Enumeration date
11/29/2006
Last updated
01/08/2010
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