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Individual

KENT M BERNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1300 SOUTH DRIVE, WINNEBAGO, WI 54985-0009
(920) 235-4910
(920) 236-2931
Mailing address
520 UNIVERSITY AVE, SUITE # 300, MADISON, WI 53703-4915
(608) 255-3340

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1266-057
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1266-057
LICENSE
WI
Enumeration date
04/13/2007
Last updated
02/16/2008
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