Healthcare Provider Details

I. General information

NPI: 1740629807
Provider Name (Legal Business Name): JOANNA SWIFT MA, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2013
Last Update Date: 06/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7410 SPRING VILLAGE DR
SPRINGFIELD VA
22150-4485
US

IV. Provider business mailing address

7410 SPRING VILLAGE DR
SPRINGFIELD VA
22150-4485
US

V. Phone/Fax

Practice location:
  • Phone: 703-923-3141
  • Fax:
Mailing address:
  • Phone: 703-923-3141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number09930
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: