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Contact Information

JESSIE J BRUNELLE, LCSW
1605 NAVAJO RD
WANSHIP, UT84017-6241
 Phone: 208-407-0588
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for JESSIE J BRUNELLE · (Female)

NPI # 1306351317
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 12/13/2017
Last updated 10/17/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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