Bergstrom, Douglas Alan
Bergstrom, Douglas Alan is an sole proprietor health care provider with primary practice located at 143 E Merritt St , Prescott AZ 86301-2028. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bergstrom, Douglas Alan can be contacted via phone (928) 445-3835.Contact Information
Primary practice address
143 E Merritt St
Prescott AZ 86301-2028
Phone: (928) 445-3835
Fax: (928) 445-7071
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 1142 | Arizona |
Profile Details
| NPI number | 1063536688 |
|---|---|
| LBN Legal business name | Bergstrom, Douglas Alan |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Popular Providers
-
Burton, Ashley
500 N Us Highway 89 , Prescott AZ 86313-5001 -
Sparks, Daryl
1042 Willow Creek Rd Ste A101 , Prescott AZ 86301-1672 -
Hodge, Elaine Arena
211 Grove Ave , Prescott AZ 86301-5737 -
Bates, Bethany
500 N Us Highway 89 , Prescott AZ 86313-5001 -
Wrabetz, Amy Beth
500 N. Hwy 89 Mhc (116), Prescott AZ 86313 -
Fallon, Daniel
143 E Merritt St , Prescott AZ 86301-2028 -
Tromp, Shannon
4499 E State Route 69 , Prescott AZ 86301-6731 -
Sullivan, Karen Lynn
143 N Mccormick St Suite 103, Prescott AZ 86301-2723