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NPI Code Detail

MEDICARE: DR. LESLIE BETH SWANSON PSY.D.

MEDICARE: DR. LESLIE BETH SWANSON PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TB0200XCognitive & Behavioral PsychologistPY6313FL
2103TC0700XClinical PsychologistPY6313FL
3103TC2200XClinical Child & Adolescent PsychologistPY6313FL
4103TF0000XFamily PsychologistPY6313FL
5103TF0200XForensic PsychologistPY6313FL

General Provider Information

NPI Number : 1013122530
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE BETH SWANSON PSY.D.
Provider Business Mailing Address
First Line : 11983 TAMIAMI TRL N
Second Line : SUITE #132
City : NAPLES
State : FL
Zip : 34110-1603
Country : US
Telephone Number : 239-649-6010
Fax Number : 239-598-1417
Provider Business Practice Location Address
First Line : 11983 TAMIAMI TRL N
Second Line : SUITE #132
City : NAPLES
State : FL
Zip : 34110-1603
Country : US
Telephone Number : 239-649-6010
Fax Number : 239-598-1417
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/10/2007
Last Update Date : 07/10/2008

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