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:
Health care specialties
| Specialty | Code | License # | 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 2 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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