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General NPI Number Information
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NPI Number | 1881934206
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Entity Type | Organization
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Legal Business Name | KAREN BERGBOWER & ASSOCIATES
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Dates
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Enumeration Date | 02/21/2013
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 10299 GRAND RIVER RD SUITE P
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City | BRIGHTON
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State | MI
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Zip | 48116-6541
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Country | US
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Telephone | 810-225-9550
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Fax |
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Provider Business Mailing Address
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Address Line | 10299 GRAND RIVER RD SUITE P
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City | BRIGHTON
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State | MI
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Zip | 48116-6541
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Country | US
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Telephone | 810-225-9550
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KAREN J BERGBOWER
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Credential |
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Telephone | 810-225-9550
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 470092
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License Number State | MI
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