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General NPI Number Information
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NPI Number | 1063650497
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Entity Type | Individual
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Provider Name | MARY-LYNN RUTH SWANSON INTERN
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Gender | Female
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 38 ROUTE 134 STE 2
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-3818
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Country | US
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Telephone | 508-694-6552
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Fax | 508-694-5127
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Provider Business Mailing Address
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Address Line | PO BOX 123 N/A
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City | YARMOUTH PORT
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State | MA
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Zip | 02675-0123
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Country | US
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Telephone | 508-694-6552
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Fax | 508-694-5127
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 116922
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License Number State | MA
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