Provider Demographics
NPI:1063685709
Name:BRUNO-ENRIGHT, JILL M (MSW)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:M
Last Name:BRUNO-ENRIGHT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BURLESON ST
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78957-1018
Mailing Address - Country:US
Mailing Address - Phone:512-535-8492
Mailing Address - Fax:
Practice Address - Street 1:2200 W 35TH ST
Practice Address - Street 2:CAMP MABRY
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-1222
Practice Address - Country:US
Practice Address - Phone:512-535-8492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010700241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical