MEDICARE: MRS. NATALIE DAWN SWINGLE

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	103TR0400X	Rehabilitation Psychologist
2	101Y00000X	Counselor

General Provider Information

NPI Number	:	1922341239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE DAWN SWINGLE

Provider Business Mailing Address
First Line	:	3744 BROADRIVER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-5456
Country	:	US
Telephone Number	:	702-764-0188
Fax Number	:

Provider Business Practice Location Address
First Line	:	3744 BROADRIVER DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89108-5456
Country	:	US
Telephone Number	:	702-764-0188
Fax Number	:

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

Provider Enumeration Date	:	04/04/2013
Last Update Date	:	05/22/2013

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