Doctor Name: | JAN E. MUGAVERO SWICK |
NPI Number: | 1013158492 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC002956 |
Business Practice Address: | 502 Fairbanks Ave Phillipsburg, NJ - 088651435 |
Business Phone Number: | 9086191769 |
Business Fax Number: | |
Mailing Address: | 502 Fairbanks Ave, PHILLIPSBURG |
State: | NJ |
Postal Code: | 088651435 |
Phone Number: | 9086191769 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2009 |
NPI Last Update Date: | 03/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC002956 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |