NPI 1164900288 · live from the CMS NPI Registry
Trent Beutler Alder, LMSW
Social Worker, Clinical in Preston, ID. National Provider Identifier 1164900288, active.
NPI record
| NPI | 1164900288 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 44 N 100 E, Preston, ID 83263 |
| Practice phone | 208-852-4107 |
| Mailing address | 1568 E 400 S, Preston, ID 83263 |
| Enumerated | July 31, 2018 |
| Last updated | July 31, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.