National Provider Identifier Database

BLAKE D ALTOM, M.S., MFT INTERN – NPI #1255657201
Foster Care Agency

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.


Contact Information

BLAKE D ALTOM, M.S., MFT INTERN
242 ROSEWOOD CIR
LOGAN, UT84321-5045
Phone: 435-512-1304
Fax:
Website:
Specialty Taxonomy Code
* Foster Care Agency 253J00000X
Marriage & Family Therapist 106H00000X

* Indicates primary specialty

NPI Profile & details for BLAKE D ALTOM

NPI Number 1255657201
Credentials M.S., MFT INTERN
Entity Individual
Enumeration date 04/15/2010
Last updated 04/15/2010 - About 16 years ago
Sole proprietor1 Yes
Identifiers
  • UT License #: 7195889-3904
Hospital affiliation n/a

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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