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Individual

MRS. PATTY (PATRICIA) J. BERTRAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC, RN, CADC

Contact information

Practice address
825 W STATE ST, #111, GENEVA, IL 60134-2080
(630) 927-2329
Mailing address
825 W STATE ST, #111, GENEVA, IL 60134-2080

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0004532117
BLUE CROSS BLUE SHIELD PP
IL
Enumeration date
08/02/2006
Last updated
07/08/2007
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