Doctor Name: | BERT A BRUNO |
NPI Number: | 1225335227 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 266606-3501 |
Business Practice Address: | 375 S Carbon Ave Box 11 Price, UT - 845012909 |
Business Phone Number: | 4356375032 |
Business Fax Number: | 4356377336 |
Mailing Address: | 375 S Carbon Ave, Box 11 PRICE |
State: | UT |
Postal Code: | 845012909 |
Phone Number: | 4356375032 |
Fax Number: | 4356377336 |
NPI Enumeration Date: | 02/28/2011 |
NPI Last Update Date: | 02/28/2011 |
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 |