Provider Demographics
NPI:1013675180
Name:ALLAN, TRENT WILLIAM (BA,AA)
Entity type:Individual
Prefix:
First Name:TRENT
Middle Name:WILLIAM
Last Name:ALLAN
Suffix:
Gender:M
Credentials:BA,AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10556 CEDAR RUN CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89135-2326
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1536 N BOULDER HWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-4120
Practice Address - Country:US
Practice Address - Phone:702-558-8600
Practice Address - Fax:702-558-8700
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)