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General NPI Number Information
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NPI Number | 1770252678
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Entity Type | Individual
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Provider Name | DARLA KAY TRENT LPC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 13900 W WAINWRIGHT DR STE 101J
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City | BOISE
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State | ID
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Zip | 83713-5028
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Country | US
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Telephone | 208-484-7448
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Fax | 888-904-3882
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Provider Business Mailing Address
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Address Line | 9855 W PENHURST DR
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City | STAR
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State | ID
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Zip | 83669-5711
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Country | US
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Telephone | 208-484-7448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-8365
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License Number State | ID
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