Organization
LOOSE CANNON SOCIAL WORK, LLC.
Active
Other names
Bruce C. Solomon
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE CRAIG SOLOMON LCSW (MANAGING PARTNER)
(801) 359-9042
Entity
Organization
Contact information
Practice address
616 S RIVER RD, #220, ST GEORGE, UT 84790-2104
(435) 359-9042
Mailing address
2298 E 200 S, ST GEORGE, UT 84790-1603
(435) 359-9043
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8202232-3501
UT
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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