Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1447882261 |
---|---|
Provider Name | Tanya S Swift |
First Address | Woodbury, MN 55125-9143 |
Second Address | Woodbury, MN 55125-9143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2020 |
Last Update Date | 10/02/2020 |