Individual
DR. BRYAN B BUSHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5030 HARRISON BLVD, OGDEN, UT 84403-4311
(801) 387-5600
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 387-5600
(801) 475-1621
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
5842642-2501
UT
103TC2200X
Clinical Child & Adolescent Psychologist
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—
Other
Enumeration date
08/19/2008
Last updated
12/05/2012
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