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General NPI Number Information
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NPI Number | 1558092932
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Entity Type | Organization
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Legal Business Name | JOANNE TERRY SWANSON, LICSW, LCSW
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 133 WATERFORD LN
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City | GEORGETOWN
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State | TX
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Zip | 78628-6905
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Country | US
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Telephone | 413-687-4057
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Fax |
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Provider Business Mailing Address
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Address Line | 133 WATERFORD LN
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City | GEORGETOWN
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State | TX
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Zip | 78628-6905
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Country | US
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Telephone | 413-687-4057
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Fax |
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Authorized Official
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Title or Position | CLINICIAN, OWNER/MANAGER
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Name | JOANNE TERRY SWANSON
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Credential | LICSW, LCSW
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Telephone | 413-687-4057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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