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General NPI Number Information
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NPI Number | 1124901830
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Entity Type | Individual
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Provider Name | MARISSA H. SWANSON PHD, LP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 210 9TH ST SE
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City | ROCHESTER
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State | MN
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Zip | 55904-6756
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Country | US
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Telephone | 507-288-3443
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Fax |
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Provider Business Mailing Address
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Address Line | 735 FOREST HILLS DR SW
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City | ROCHESTER
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State | MN
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Zip | 55902-2269
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Country | US
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Telephone | 412-478-3418
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-2023-0067
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | GL0141
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License Number State | MN
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