Individual
AUSTIN BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAMFT
Contact information
Practice address
568 E 1400 S, OREM, UT 84097-7714
(801) 621-6510
Mailing address
568 E 1400 S, OREM, UT 84097-7714
(801) 854-7942
(801) 854-7943
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
870299862
NONE
UT
Enumeration date
05/02/2019
Last updated
10/30/2020
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