Healthcare Provider Details

I. General information

NPI: 1245653757
Provider Name (Legal Business Name): CHRISTINE SWIFT MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2014
Last Update Date: 02/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6416 MELALEUCA LN
GREENACRES FL
33463-3807
US

IV. Provider business mailing address

3674 BROOKLYN LN
LAKE WORTH FL
33461-5423
US

V. Phone/Fax

Practice location:
  • Phone: 561-649-0877
  • Fax:
Mailing address:
  • Phone: 561-707-2166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: