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General NPI Number Information
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NPI Number | 1275838203
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Entity Type | Individual
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Provider Name | SUSAN ANN SWANK PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2011
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 3225 TEMPLETON GAP RD SUITE 101
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-8728
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Country | US
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Telephone | 719-439-5683
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Fax | 719-352-3827
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Provider Business Mailing Address
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Address Line | 822 N SHERIDAN AVE
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-4524
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Country | US
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Telephone | 719-439-5683
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Fax | 719-255-3302
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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 | 3580
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License Number State | CO
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