Bergeron, Tanisha

Bergeron, Tanisha is an sole proprietor health care provider with primary practice located at 6 School Rd , Moodus CT 06469-1168. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Bergeron, Tanisha can be contacted via phone (860) 638-8612.

Contact Information

Primary practice address
6 School Rd Moodus CT 06469-1168
Phone: (860) 638-8612
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 005002 Connecticut

Profile Details

NPI number 1285910638
LBN Legal business name Bergeron, Tanisha
Credentials MA.CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2011
Last updated Dec 1st, 2016 - 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.

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