Doctor Name: | JODI JEAN SWAJA |
NPI Number: | 1376612606 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 13292 |
Business Practice Address: | 7675 Highway 13 W Suite 102 Savage, MN - 553781181 |
Business Phone Number: | 9528087700 |
Business Fax Number: | 9528087711 |
Mailing Address: | 103 5th Avenue East, SHAKOPEE |
State: | MN |
Postal Code: | 55379 |
Phone Number: | 9524039563 |
Fax Number: | |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 13292 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |