Provider Demographics
NPI:1538437710
Name:BERGMAN, CHRISTINA (MA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BERGMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:N/
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:2318 QUEEN MORGAN LN
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-5546
Mailing Address - Country:US
Mailing Address - Phone:972-824-9774
Mailing Address - Fax:866-646-0383
Practice Address - Street 1:2318 QUEEN MORGAN LN
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75056
Practice Address - Country:US
Practice Address - Phone:972-824-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist