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General NPI Number Information
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NPI Number | 1689130742
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Entity Type | Individual
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Provider Name | JAMIE SWENSON
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Gender | Female
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Dates
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Enumeration Date | 02/13/2019
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 20 E MILWAUKEE ST STE 211
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City | JANESVILLE
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State | WI
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Zip | 53545-3061
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Country | US
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Telephone | 608-449-2356
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 BENNETT ST
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City | JANESVILLE
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State | WI
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Zip | 53545-1804
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Country | US
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Telephone | 608-931-6771
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9898-123
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License Number State | WI
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