Provider Demographics
NPI:1841614138
Name:JONES, BRONSON
Entity Type:Individual
Prefix:
First Name:BRONSON
Middle Name:
Last Name:JONES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 S 800 W
Mailing Address - Street 2:
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-2400
Mailing Address - Country:US
Mailing Address - Phone:435-723-8548
Mailing Address - Fax:
Practice Address - Street 1:8606 N 11600 W
Practice Address - Street 2:
Practice Address - City:THATCHER
Practice Address - State:UT
Practice Address - Zip Code:84337-9103
Practice Address - Country:US
Practice Address - Phone:435-854-7295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor