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General NPI Number Information
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NPI Number | 1083854830
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Entity Type | Individual
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Provider Name | JESSICA JILL SWANSON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 7243 E MAIN RD
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City | WESTFIELD
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State | NY
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Zip | 14787-9661
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Country | US
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Telephone | 716-969-0245
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Fax |
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Provider Business Mailing Address
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Address Line | 7243 E. MAIN RD
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City | WESTFIELD
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State | NY
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Zip | 14787
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Country | US
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Telephone | 716-969-0245
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 018215-1
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License Number State | NY
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