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General NPI Number Information
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NPI Number | 1548059298
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Entity Type | Individual
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Provider Name | DESIREE LEIGH SWENDSEN
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Gender |
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 50 FITCH ST
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City | NEW HAVEN
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State | CT
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Zip | 06515-1366
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Country | US
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Telephone | 203-361-9166
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Fax |
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Provider Business Mailing Address
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Address Line | 328 PARK AVE
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City | BRIDGEPORT
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State | CT
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Zip | 06604-5453
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Country | US
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Telephone | 475-344-8560
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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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