Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101Y00000X | Counselor | MO | |
N | 101YM0800X | Mental Health Counselor | MO | |
Y | 101YP2500X | Professional Counselor | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | MO | |
N | 103TF0000X | Family Psychologist | MO | |
N | 103TH0100X | Health Service | MO |
NPI | 1275987281 |
---|---|
Provider Name | Teresa Swanson |
First Address | Waynesville, MO 65583-3375 |
Second Address | Waynesville, MO 65583-3375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2016 |
Last Update Date | 15/04/2016 |