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General NPI Number Information
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NPI Number | 1710220157
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Entity Type | Individual
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Provider Name | FELICIA MARIE BERGMAN PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 08/27/2019
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Provider Practice Location Address
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Address Line | 5851 PEARL RD #305
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130-2113
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Country | US
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Telephone | 440-845-9011
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Fax | 440-845-9013
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Provider Business Mailing Address
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Address Line | 5851 PEARL RD SUITE 305
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City | PARMA HEIGHTS
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State | OH
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Zip | 44130-2113
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Country | US
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Telephone | 440-845-9011
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Fax | 440-845-9013
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 7008
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License Number State | OH
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