Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003130311 |
---|---|
Provider Name | Miss Jessica Lynn Swible |
First Address | Beverly, MA 01915-3524 |
Second Address | Peabody, MA 01960-7939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2010 |
Last Update Date | 16/03/2010 |