Destadler, Bronson
Destadler, Bronson is an individual health care provider with primary practice located at 143 State St , Newburyport MA 01950-6621. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Destadler, Bronson can be contacted via phone (978) 462-2890.Contact Information
Primary practice address
143 State St
Newburyport MA 01950-6621
Phone: (978) 462-2890
Fax: (978) 462-2890
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 106400 | Massachusetts |
Profile Details
| NPI number | 1073514196 |
|---|---|
| LBN Legal business name | Destadler, Bronson |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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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