Healthcare Provider Details

I. General information

NPI: 1346555323
Provider Name (Legal Business Name): MRS. TRINA SWALBERG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2010
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 W 3000 N
MONROE UT
84754-3270
US

IV. Provider business mailing address

95 W 3000 N
MONROE UT
84754-3270
US

V. Phone/Fax

Practice location:
  • Phone: 435-527-3191
  • Fax: 435-527-3076
Mailing address:
  • Phone: 435-527-3191
  • Fax: 435-527-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number63156
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: