Individual
BRYNN OPAL PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
898 S STATE ST, OREM, UT 84097-7044
(385) 230-7290
Mailing address
2316 W 510 N, PROVO, UT 84601-7227
(435) 851-9746
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
UT
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/22/2021
Last updated
02/18/2026
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