Individual
MARK C BRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LICSW
Contact information
Practice address
855 MANKATO AVENUE, WINONA, MN 55987-0006
(507) 457-4484
(507) 457-4160
Mailing address
855 MANKATO AVENUE, PO BOX 5600, WINONA, MN 55987-0006
(507) 457-4160
(507) 457-4160
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2101
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
093K4BR
BCBS
MN
Enumeration date
10/19/2006
Last updated
07/08/2007
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