Provider Demographics
NPI:1841574571
Name:BERGL, NATALIE (BSW)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:
Last Name:BERGL
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:MRS
Other - First Name:NATALIE
Other - Middle Name:
Other - Last Name:YODER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSW
Mailing Address - Street 1:2349 RENAISSANCE DR.
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119
Mailing Address - Country:US
Mailing Address - Phone:702-739-7716
Mailing Address - Fax:
Practice Address - Street 1:2349 RENAISSANCE DR
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6191
Practice Address - Country:US
Practice Address - Phone:702-739-7716
Practice Address - Fax:702-597-2242
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner