Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY6313 | FL |
Y | 103G00000X | Clinical Psychologist | PY6313 | FL |
Y | 103TC0700X | Clinical Psychologist | PY6313 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY6313 | FL |
N | 103TF0000X | Family Psychologist | PY6313 | FL |
N | 103TF0200X | Forensic Psychologist | PY6313 | FL |
NPI | 1013122530 |
---|---|
Provider Name | Dr. Leslie Beth Swanson |
First Address | Naples, FL 34110-1603 |
Second Address | Naples, FL 34110-1603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 10/07/2008 |