Whalio Doctors

NPI 1154501682

Douglas A. Bergstrom, PH.D., PLLC

Organisation Community/Behavioral Health Agency Prescott, AZ

Practice location

Address
143 E Merritt St, Prescott, AZ 86301-2028
Phone
(928) 445-3835
Fax
(928) 445-7071

Authorised official

Name
Douglas Alan Bergstrom
Title
Psychologist
Phone
(928) 445-3835

Registered specialties

Community/Behavioral Health Agency Primary
Agencies Taxonomy 251S00000X Licence 1142 (AZ)

Registry record

NPI
1154501682
Entity type
Organization
NPI issued
13 Nov 2007
Record last updated
13 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.