Provider Demographics
NPI:1396999454
Name:BERTEL, NORMAN VICTOR (PSYD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:VICTOR
Last Name:BERTEL
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26700 S US HIGHWAY 85
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-5024
Mailing Address - Country:US
Mailing Address - Phone:623-386-6160
Mailing Address - Fax:
Practice Address - Street 1:26700 S US HIGHWAY 85
Practice Address - Street 2:
Practice Address - City:BUCKEYE
Practice Address - State:AZ
Practice Address - Zip Code:85326-5024
Practice Address - Country:US
Practice Address - Phone:623-386-6160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3362103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical