Individual
MR. BRUCE JENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
410 N 100 E, KOOSHAREM, UT 84744-7700
(435) 638-7318
Mailing address
PO BOX 440219, KOOSHAREM, UT 84744-0219
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
141354-3501
UT
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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