Individual
MR. GORDON SCOTT BRUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
151 S UNIVERSITY AVE STE 3200, PROVO, UT 84601-4427
(801) 851-7167
Mailing address
151 S UNIVERSITY AVE STE 3200, PROVO, UT 84601-4427
(801) 851-7167
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
370578-6004
UT
Other
Enumeration date
11/18/2010
Last updated
11/18/2010
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