Provider Demographics
NPI:1346555323
Name:SWALBERG, TRINA
Entity Type:Individual
Prefix:MRS
First Name:TRINA
Middle Name:
Last Name:SWALBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 W 3000 N
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:UT
Mailing Address - Zip Code:84754-3270
Mailing Address - Country:US
Mailing Address - Phone:435-527-3191
Mailing Address - Fax:435-527-3076
Practice Address - Street 1:95 W 3000 N
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:UT
Practice Address - Zip Code:84754-3270
Practice Address - Country:US
Practice Address - Phone:435-527-3191
Practice Address - Fax:435-527-3076
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT63156101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool