Individual
NIKKI MARIE BERGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11901 JESSICA LN, RAYTOWN, MO 64138-2639
(186) 203-8513
Mailing address
1620 NW 75TH ST, KANSAS CITY, MO 64118-8390
(816) 682-7804
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2021050567
MO
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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