Doctor Name: | CHARLOTTE BERTRAND |
NPI Number: | 1215343132 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., P.L.M.H.C. |
License Number: | 072723 |
Business Practice Address: | 118 N Elm St Avoca, IA - 515213510 |
Business Phone Number: | 7123076014 |
Business Fax Number: | |
Mailing Address: | 118 N Elm St, AVOCA |
State: | IA |
Postal Code: | 515213510 |
Phone Number: | 7123076014 |
Fax Number: | |
NPI Enumeration Date: | 07/11/2014 |
NPI Last Update Date: | 07/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 072723 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |