Healthcare Provider Details

I. General information

NPI: 1639570260
Provider Name (Legal Business Name): ESTHER NICOLE BERMAN B.ED, MSHS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17507 LEE HWY
ABINGDON VA
24210-7835
US

IV. Provider business mailing address

17507 LEE HWY
ABINGDON VA
24210-7835
US

V. Phone/Fax

Practice location:
  • Phone: 276-525-6043
  • Fax: 888-233-7885
Mailing address:
  • Phone: 276-525-6043
  • Fax: 888-233-7885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number134000246
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: