Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1029 | LA |
Y | 103T00000X | Psychologist | 1029 | LA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1029 | LA |
N | 103TM1800X | Intellectual & Developmental Disabilities | 1029 | LA |
NPI | 1073749891 |
---|---|
Provider Name | Cielo H. Berner |
First Address | Hammond, LA 70401-2312 |
Second Address | Hammond, LA 70401-2312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 06/12/2011 |