Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 6301003837 | MI |
Y | 103T00000X | Psychologist | 6301003837 | MI |
N | 104100000X | Social Worker | 6801063189 | MI |
NPI | 1013196153 |
---|---|
Provider Name | Dennis A Berger |
First Address | Warren, MI 48092-2468 |
Second Address | Rochester Hills, MI 48307-5160 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2007 |
Last Update Date | 25/10/2007 |