Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 6301003399 | MI |
N | 103T00000X | Psychologist | 6301003399 | MI |
N | 103TA0700X | Adult Development & Aging Psychologist | 6301003399 | MI |
N | 103G00000X | Clinical Psychologist | 6301003399 | MI |
N | 103TC0700X | Clinical Psychologist | 6301003399 | MI |
N | 103TR0400X | Rehabilitation Psychologist | 6301003399 | MI |
NPI | 1356391304 |
---|---|
Provider Name | Dr. Darlene Ann Swiderski |
First Address | Clinton Township, MI 48038-1467 |
Second Address | Warren, MI 48088-4729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R67504 | (02) | MI |