IndividualActive
Braelee Bergon
NPI 1700456852 · Social Worker · Logan, UT
Provider details
- NPI number
- 1700456852
- Entity type
- Individual
- Primary specialty
- Social WorkerBehavioral Health & Social Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 12338791-3503 (UT)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
90 E 200 N
Logan, UT 84321-4034
Phone: (435) 752-0750
Approximate (ZIP-level) locationGet directions
Mailing address
53 W 1150 N Apt 2
Logan, UT 84341-6858
Registry dates
- Enumerated
- 2021-06-30
- Last updated
- 2021-06-30
- Certified
- 2021-06-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.