Healthcare Provider Details

I. General information

NPI: 1639461528
Provider Name (Legal Business Name): JAMIE HOHL SWIT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2011
Last Update Date: 05/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 ELIZABETH ST
BARABOO WI
53913-2372
US

IV. Provider business mailing address

708 ELIZABETH ST
BARABOO WI
53913-2372
US

V. Phone/Fax

Practice location:
  • Phone: 608-477-9858
  • Fax: 608-742-3636
Mailing address:
  • Phone: 608-477-9858
  • Fax: 608-742-3636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1778-127
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: