Douglas Alan Bergstrom, PH.D.

NPI #1063536688 in Prescott, Arizona

Provider Information

NPI Number: 1063536688
Entity Type: Individual
Name: Douglas Alan Bergstrom, PH.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist - Clinical
Credential: PH.D.
Enumeration Date: Mar 19, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 143 E MERRITT ST
City: Prescott
State: Arizona
ZIP Code: 86301-2028
Phone: (928) 445-3835

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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