Black, Bronson Michael

Black, Bronson Michael is an individual health care provider with primary practice located at 2500 S State St , South Salt Lake UT 84115-3164. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Black, Bronson Michael can be contacted via phone (385) 646-1841.

Contact Information

Primary practice address
2500 S State St South Salt Lake UT 84115-3164
Phone: (385) 646-1841
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 101YS0200X

Profile Details

NPI number 1487392221
LBN Legal business name Black, Bronson Michael
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2022
Last updated May 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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