Organization Name: | BERT BRUNO |
NPI Number: | 1073909644 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BERT BRUNO (OWNER) |
Mailing Address: | 375 S Carbon Ave Suite B-11 Price |
State: | UT US |
Postal Code: | 845012909 |
Phone Number: | 4356375032 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2015 |
NPI Last Update Date: | 04/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 266606-3501 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | UT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |