Provider Demographics
NPI:1487420741
Name:BERG, TERESA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:ANN
Last Name:BERG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 W VAIL ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-0239
Mailing Address - Country:US
Mailing Address - Phone:918-260-1514
Mailing Address - Fax:
Practice Address - Street 1:2109 W VAIL ST
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-0239
Practice Address - Country:US
Practice Address - Phone:918-260-1514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula