Bergmann, Samantha
Bergmann, Samantha is an individual health care provider with primary practice located at 8239 W Hillview Dr , Mequon WI 53097-3205. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Bergmann, Samantha can be contacted via phone (402) 319-3770.Contact Information
Primary practice address
8239 W Hillview Dr
Mequon WI 53097-3205
Phone: (402) 319-3770
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 84-140 | Wisconsin |
Profile Details
| NPI number | 1861872814 |
|---|---|
| LBN Legal business name | Bergmann, Samantha |
| Credentials | MA, BCBA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2015 |
| Last updated | Jan 10th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861872814 | NPPES |
| Wisconsin | Other | 13608635 | CAQH |
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