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Individual

MRS. INGRID ROSE BERGEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
635 W WHEAT RD, VINELAND, NJ 08360-1973
(856) 692-6673
Mailing address
635 W WHEAT RD, VINELAND, NJ 08360-1973
(856) 692-6673

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
46TA09024500
NJ

Other

Enumeration date
07/08/2015
Last updated
07/08/2015
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