Provider Demographics
NPI:1871814038
Name:BJERG, ANNE CHRISTINE (PHD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:CHRISTINE
Last Name:BJERG
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 1:269 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3301
Mailing Address - Country:US
Mailing Address - Phone:617-547-2255
Mailing Address - Fax:617-547-0003
Practice Address - Street 1:269 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3301
Practice Address - Country:US
Practice Address - Phone:617-547-2255
Practice Address - Fax:617-547-0003
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10373103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical