Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | COO5332 | NC |
NPI | 1003023326 |
---|---|
Provider Name | Ms. Judith Merai Swayne |
First Address | Lewisville, TX 75056-5559 |
Second Address | Asheville, NC 28805-4304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 29/10/2018 |