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General NPI Number Information
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NPI Number | 1710529417
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Entity Type | Individual
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Provider Name | JOHN JAMES SWANGLER
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Gender | Male
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 3202 MARK TWAIN DR
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City | PINETOP
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State | AZ
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Zip | 85935-8619
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Country | US
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Telephone | 205-767-5064
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Fax |
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Provider Business Mailing Address
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Address Line | 5346 S COUNTY ROAD 405
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City | NEWBERRY
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State | MI
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Zip | 49868-8028
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Country | US
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Telephone | 205-767-5064
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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 | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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