Provider Demographics
NPI:1346077476
Name:MUNSON, BRONTE (LLMSW)
Entity type:Individual
Prefix:
First Name:BRONTE
Middle Name:
Last Name:MUNSON
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7035 ORCHARD LAKE RD STE 800
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-5301
Mailing Address - Country:US
Mailing Address - Phone:248-669-9500
Mailing Address - Fax:
Practice Address - Street 1:7035 ORCHARD LAKE RD STE 800
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-5301
Practice Address - Country:US
Practice Address - Phone:248-669-9500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851116343104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker