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General NPI Number Information
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NPI Number | 1003542093
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Entity Type | Individual
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Provider Name | KATELYN ELIZABETH SWINFORD
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Gender | Female
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Dates
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Enumeration Date | 08/01/2022
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 304 ENTERPRISE DR
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City | OXFORD
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State | MS
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Zip | 38655-2762
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Country | US
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Telephone | 662-638-3538
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Fax | 662-638-3532
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Provider Business Mailing Address
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Address Line | 403 SISK AVE
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City | OXFORD
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State | MS
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Zip | 38655-3409
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Country | US
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Telephone | 256-343-1758
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P-0624
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License Number State | MS
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