Provider Demographics
NPI:1225395932
Name:BERTRAND, NAOMI LYNNE
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:LYNNE
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BARLOWS LANDING RD
Mailing Address - Street 2:SUITE 13
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559-1980
Mailing Address - Country:US
Mailing Address - Phone:508-563-5767
Mailing Address - Fax:508-563-5774
Practice Address - Street 1:4 BARLOWS LANDING RD
Practice Address - Street 2:SUITE 13
Practice Address - City:POCASSET
Practice Address - State:MA
Practice Address - Zip Code:02559-1980
Practice Address - Country:US
Practice Address - Phone:508-563-5767
Practice Address - Fax:508-563-5774
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst