Provider Demographics
NPI:1033586938
Name:TEUSCHER, BRYAN (LCSW)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:
Last Name:TEUSCHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3384 E SUMMERHILL DR
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84121-5427
Mailing Address - Country:US
Mailing Address - Phone:208-604-4355
Mailing Address - Fax:
Practice Address - Street 1:5663 S REDWOOD RD
Practice Address - Street 2:SUITE 2, OFFICE 10
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5387
Practice Address - Country:US
Practice Address - Phone:208-604-4355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9817792-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical