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General NPI Number Information
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NPI Number | 1962299586
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Entity Type | Individual
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Provider Name | ELLIE SWANGER
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 1610 28TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2641
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Country | US
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Telephone | 888-531-2204
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Fax |
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Provider Business Mailing Address
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Address Line | 585 WHITE GRAVEL MCDANIEL RD
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City | MINFORD
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State | OH
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Zip | 45653-8812
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Country | US
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Telephone | 740-981-9150
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | COND.20242865-SP
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License Number State | OH
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