Mr Blake Denver Altom, MS, MFT INTERN - Couples Therapy in Logan, UT

Mr Blake Denver Altom, MS, MFT INTERN is a Foster Care Agency based in Logan, Utah. Mr Blake Denver Altom is licensed to practice in * (Not Available) (license number ) and his current practice location is 242 Rosewood Cir, Logan, Utah. He can be reached at his office (for appointments etc.) via phone at (435) 512-1304.

NPI number for Mr Blake Denver Altom is 1255657201 and his current mailing address is 242 Rosewood Cir, Logan, Utah. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255657201.

Contact Information

Mr Blake Denver Altom, MS, MFT INTERN
242 Rosewood Cir,
Logan, UT 84321-5045
(435) 512-1304
Not Available

Healthcare Provider's Profile

Full NameMr Blake Denver Altom
GenderMale
SpecialityFoster Care Agency
Location242 Rosewood Cir, Logan, Utah
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1255657201
  • Provider Enumeration Date: 04/15/2010
  • Last Update Date: 04/15/2010

Medical Identifiers

Medical identifiers for Mr Blake Denver Altom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255657201NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
106H00000XMarriage & Family Therapist 7195889-3904 (Utah)Secondary
253J00000XFoster Care Agency (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Blake Denver Altom is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Blake Denver Altom, MS, MFT INTERN
242 Rosewood Cir,
Logan, UT 84321-5045

Ph: (435) 512-1304
Mr Blake Denver Altom, MS, MFT INTERN
242 Rosewood Cir,
Logan, UT 84321-5045

Ph: (435) 512-1304

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Foster Care Agency in Logan, UT


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