Most Relevant Information
Provider Data
| NPI Number: | 1003469990 |
| Provider Name: | WILLIAM BERGMANN |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/19/2019 |
| Last Updated: | 07/19/2019 |
Provider Practice Location
1491 MAIN ST
WILLIMANTIC
CT
062261914
Practice Location Phone/Fax
| Phone: | 8604563215 |
| Fax: |
Provider Mailing Location
2 WATERSIDE XING STE 401
WINDSOR
CT
060951587
Provider Mailing Phone/Fax
| Phone: | 8606973351 |
| Fax: | 8607315536 |