Individual
MRS. DEBBIE JO BERTOLINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSW
Contact information
Practice address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
(801) 373-4760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
130294-3503
UT
104100000X
Social Worker
Primary
130294-3503
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1043516966
—
UT
Enumeration date
02/10/2011
Last updated
08/15/2024
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