MR. BLAKE DENVER ALTOM M.S. MFT INTERN NPI 1255657201

NPI Information

MR. Blake Denver Altom, M.S., MFT INTERN is a foster care agency in Logan, UT. The provider is a Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as 24-hour substitute care for children outside their own homes. Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. MR. Blake Denver Altom, M.S., MFT INTERN NPI is 1255657201. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

242 ROSEWOOD CIR
LOGAN, UT
ZIP 84321-045
Phone: (435) 512-1304

The enumeration date for this NPI number is 4/15/2010 and was last updated on 4/15/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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