Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT2002 | CA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2002 OT | CA |
NPI | 1003039983 |
---|---|
Provider Name | Steffanie Swenson |
First Address | Beaumont, CA 92223-7192 |
Second Address | Redlands, CA 92373-4775 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 31/08/2020 |