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General NPI Number Information
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NPI Number | 1891224788
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Entity Type | Organization
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Legal Business Name | SWANN WELLNESS GROUP
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 06/05/2017
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Provider Practice Location Address
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Address Line | 530 BEACON PKWY W STE 740
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City | BIRMINGHAM
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State | AL
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Zip | 35209-3196
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Country | US
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Telephone | 205-986-9130
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Fax | 205-449-3160
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Provider Business Mailing Address
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Address Line | PO BOX 141
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City | ADAMSVILLE
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State | AL
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Zip | 35005-0141
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Country | US
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Telephone | 205-986-9130
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Fax | 205-449-3160
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DEANNA HATCHER
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Credential | LPC
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Telephone | 205-986-9130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2461
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License Number State | AL
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