Provider Demographics
NPI:1821633843
Name:BUNNELL & VIERIG LLC
Entity Type:Organization
Organization Name:BUNNELL & VIERIG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MCKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIERIG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:702-561-1603
Mailing Address - Street 1:1538 E WINWARD DR
Mailing Address - Street 2:
Mailing Address - City:HOLLADAY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-7536
Mailing Address - Country:US
Mailing Address - Phone:702-561-1603
Mailing Address - Fax:
Practice Address - Street 1:4568 S HIGHLAND DR STE 380
Practice Address - Street 2:
Practice Address - City:MILLCREEK
Practice Address - State:UT
Practice Address - Zip Code:84117-4213
Practice Address - Country:US
Practice Address - Phone:385-448-0835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty