Individual
LANDON BERGER
Active
Individual
LANDON BERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2255
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9049971
DRIVERS LICENSE
OR
Enumeration date
06/28/2013
Last updated
03/29/2021
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