Individual
MR. MICHAEL JAMES BRUNO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC I, CRM
Contact information
Practice address
548 SE JACKSON ST, ROSEBURG, OR 97470-2709
(541) 672-2691
(541) 673-5642
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
(541) 673-5642
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-11-14U
OR
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
02/04/2016
Last updated
04/18/2023
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