Individual
DR. KATHLEEN LEILANI BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
, MSW, LCSW, PH.D.
Contact information
Practice address
9739 MANHEIM LN, LAS VEGAS, NV 89117-6921
(702) 301-3417
Mailing address
9739 MANHEIM LN, LAS VEGAS, NV 89117-6921
(702) 301-3417
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5485-C
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100508688
—
NV
Enumeration date
05/23/2006
Last updated
08/02/2009
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