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1295037521
GORDON SCOTT BRUIN
PROVO, UT
NPI
1295037521
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: UT 370578-6004)
Enumeration Date
2010-11-18
Last Update Date
2010-11-18
Business Address
Mr. GORDON SCOTT BRUIN M.A.
151 S UNIVERSITY AVE STE 3200
PROVO, UT 84601-4427
Phone number: 801-851-7167
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Mailing Address
Mr. GORDON SCOTT BRUIN M.A.
151 S UNIVERSITY AVE STE 3200
PROVO, UT 84601-4427
Phone number: 801-851-7167
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