MEDICARE: DAWN J SWANSON M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6090	MN

General Provider Information

NPI Number	:	1629280953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN J SWANSON M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	300 1ST AVE NW
Second Line	:	SUITE 200
City	:	ROCHESTER
State	:	MN
Zip	:	55901-2830
Country	:	US
Telephone Number	:	507-298-2222
Fax Number	:	507-298-2227

Provider Business Practice Location Address
First Line	:	300 1ST AVE NW
Second Line	:	SUITE 200
City	:	ROCHESTER
State	:	MN
Zip	:	55901-2830
Country	:	US
Telephone Number	:	507-298-2222
Fax Number	:	507-298-2227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/30/2008

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