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General NPI Number Information
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NPI Number | 1437621802
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Entity Type | Individual
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Provider Name | RICHARD EDWARD SWANSON
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Gender | Male
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Dates
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Enumeration Date | 12/26/2018
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 700 SOUTH DR STE 203
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-4026
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Country | US
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Telephone | 845-452-5772
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Fax |
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Provider Business Mailing Address
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Address Line | 700 SOUTH DR STE 203
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-4026
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Country | US
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Telephone | 845-452-5772
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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