MEDICARE: ROBYN SWENSON PHD., LP

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
1	103T00000X	Psychologist	LP4312	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2444722	OTHER	MN	AMERICA'S PPO
2	39Q41BU	OTHER	MN	BCBS GRP
3	HP65873	OTHER	MN	HEALTHPARTNERS
4	61-69628	OTHER	MN	MEDICA
5	11N40ZU	OTHER	MN	BCBS INDIV

General Provider Information

NPI Number	:	1326025313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN SWENSON PHD., LP

Provider Business Mailing Address
First Line	:	1755 SOUTHCROSS DR W
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55306-7012
Country	:	US
Telephone Number	:	952-898-5020
Fax Number	:	952-898-5858

Provider Business Practice Location Address
First Line	:	1755 SOUTHCROSS DR W
Second Line	:
City	:	BURNSVILLE
State	:	MN
Zip	:	55306-7012
Country	:	US
Telephone Number	:	952-898-5020
Fax Number	:	952-898-5858

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2005
Last Update Date	:	02/06/2008

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Directions to “ ROBYN SWENSON PHD., LP” Practice Location

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