Healthcare Provider Details

I. General information

NPI: 1083397046
Provider Name (Legal Business Name): SHAWNA DANIELLE SWANSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 N COLLEGE ST STE D
AUBURN AL
36830-3815
US

IV. Provider business mailing address

318 N COLLEGE ST STE D
AUBURN AL
36830-3815
US

V. Phone/Fax

Practice location:
  • Phone: 334-750-7785
  • Fax:
Mailing address:
  • Phone: 334-750-7785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberALC05773
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: