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Organization
BONSAI THERAPY LLC
Active
Organization
BONSAI THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYNLEE SHULTS LCSW (OWNER)
(435) 592-4932
Entity
Organization
Contact information
Practice address
100 S GENEVA RD UNIT B206, VINEYARD, UT 84059-5375
(435) 592-4932
Mailing address
100 S GENEVA RD UNIT B206, VINEYARD, UT 84059-5375
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
08/10/2026
Last updated
08/10/2026
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