Provider Demographics
NPI:1548448699
Name:BERGER, JOAN ELDODT (PHD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:ELDODT
Last Name:BERGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6390 LBJ FREEWAY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6442
Mailing Address - Country:US
Mailing Address - Phone:972-239-9014
Mailing Address - Fax:972-239-4760
Practice Address - Street 1:6390 LBJ FREEWAY
Practice Address - Street 2:SUITE 107
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6442
Practice Address - Country:US
Practice Address - Phone:972-239-9014
Practice Address - Fax:972-239-4760
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1472103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist