Provider Demographics
NPI:1407317597
Name:BERMUDEZ, ESTHER CARMEN
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:CARMEN
Last Name:BERMUDEZ
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 1:208 CULLUM AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4534
Mailing Address - Country:US
Mailing Address - Phone:509-946-5918
Mailing Address - Fax:509-946-9827
Practice Address - Street 1:208 CULLUM AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4534
Practice Address - Country:US
Practice Address - Phone:509-946-5918
Practice Address - Fax:509-946-9827
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health