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 17 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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