Healthcare Provider Details

I. General information

NPI: 1346607546
Provider Name (Legal Business Name): MR. DALTON LEE SWAFFORD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 SOUTH BLVD
KETTERING OH
45419-2440
US

IV. Provider business mailing address

2637 SOUTH BLVD
KETTERING OH
45419-2440
US

V. Phone/Fax

Practice location:
  • Phone: 937-671-7329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.2607445
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: