Tanisha Bergeron, MACCC-SLP is a
Behavior Analyst based in Moodus, Connecticut. Tanisha Bergeron is licensed to practice in * (Not Available) (license number ) and her current practice location is
6 School Rd, Moodus, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 638-8612.
NPI number for Tanisha Bergeron is 1285910638 and her current mailing address is 6 School Rd, Moodus, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1285910638.
Healthcare Provider's Profile
| Full Name | Tanisha Bergeron |
|---|
| Gender | Female |
|---|
| Speciality | Behavior Analyst |
|---|
| Location | 6 School Rd, Moodus, Connecticut |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1285910638
- Provider Enumeration Date: 10/31/2011
- Last Update Date: 12/01/2016
Medical Identifiers
Medical identifiers for Tanisha Bergeron such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1285910638 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 235Z00000X | Speech-language Pathologist | 005002 (Connecticut) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tanisha Bergeron is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Tanisha Bergeron, MACCC-SLP 6 School Rd, Moodus, CT 06469-1168 Ph: (860) 638-8612 | Tanisha Bergeron, MACCC-SLP 6 School Rd, Moodus, CT 06469-1168 Ph: (860) 638-8612 |
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