| Doctor Name: | JESSICA BERGMAN |
| NPI Number: | 1679983753 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. SLP-CCC |
| License Number: | 8973 |
| Business Practice Address: | 615 Becker Ave Sw Willmar, MN - 562013233 |
| Business Phone Number: | 3202147011 |
| Business Fax Number: | 3202351092 |
| Mailing Address: | 615 Becker Ave Sw, WILLMAR |
| State: | MN |
| Postal Code: | 562013233 |
| Phone Number: | 3202147011 |
| Fax Number: | 3202351092 |
| NPI Enumeration Date: | 04/29/2014 |
| NPI Last Update Date: | 08/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 8973 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |