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General NPI Number Information
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NPI Number | 1780124693
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN BEHAVIORAL CONSULTANTS
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 45 N STATE ST STE 3
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City | SALINA
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State | UT
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Zip | 84654-1363
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Country | US
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Telephone | 435-691-3223
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Fax | 435-529-2030
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Provider Business Mailing Address
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Address Line | 45 N STATE ST STE 3
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City | SALINA
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State | UT
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Zip | 84654-1363
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Country | US
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Telephone | 435-691-3223
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Fax | 435-529-2030
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | BRANDON M BURR
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Credential | LCSW
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Telephone | 435-691-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 341335-6004
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License Number State | UT
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