Mutsumi Bramble
Individual provider Active NPI School Psychologist · South Salt Lake, UT
NPI 1770124299 · NPPES record last updated May 16, 2022
Key facts
- NPI
- 1770124299
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 2500 S State St
South Salt Lake, UT 84115-3164 - Phone
- (385) 646-5000
- NPI assigned
- Oct 6, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10088318-6009 | UT | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 10088318-6009 | UT | |
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
2500 S State St
South Salt Lake, UT 84115-3164
Mailing address
1529 E 3115 S
SLC, UT 84106-3455
Other practice location 1
5691 S Redwood Rd Unit 16
Taylorsville, UT 84123-5485
Phone (801) 265-3895
Other providers in South Salt Lake, UT
- Angelina Black
- Bronson Michael Black
- Matthew James Black
- Abigail Blanco
- Sarah Bradley
- Shannon Brereton
- Jessica Lynn Brinkerhoff
- Alicia Brown
- Stasi Taj Brown
- Donald Alexander Bruey
All providers in South Salt Lake, UT · School Psychologist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.