Healthcare Provider Details

I. General information

NPI: 1134544406
Provider Name (Legal Business Name): EMILY SWOGGER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2014
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 FM 967 # A
BUDA TX
78610-2884
US

IV. Provider business mailing address

150 N MILLER RD STE 150A
FAIRLAWN OH
44333-3713
US

V. Phone/Fax

Practice location:
  • Phone: 512-295-2273
  • Fax: 512-295-2280
Mailing address:
  • Phone: 330-630-1860
  • Fax: 330-630-3198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.008584
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: