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General NPI Number Information
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NPI Number | 1245986736
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Entity Type | Individual
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Provider Name | FARIN MARIE SWAN LPC
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Gender | Female
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Dates
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Enumeration Date | 02/23/2022
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Last Update Date | 02/23/2022
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Provider Practice Location Address
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Address Line | 16312 TRUMAN RD UNIT 4112
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City | ELLISVILLE
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State | MO
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Zip | 63011-4757
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Country | US
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Telephone | 314-629-3404
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Fax |
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Provider Business Mailing Address
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Address Line | 16312 TRUMAN RD UNIT 4112
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City | ELLISVILLE
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State | MO
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Zip | 63011-4757
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Country | US
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Telephone | 314-629-3404
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2013014440
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License Number State | MO
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