Doctor Name: | MR. DAVID SWANNER |
NPI Number: | 1619910619 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS, LPC, NCC |
License Number: | 1728 |
Business Practice Address: | 112 W Main St Purcell, OK - 730804220 |
Business Phone Number: | 4055271785 |
Business Fax Number: | 4055271084 |
Mailing Address: | Po Box 662, PURCELL |
State: | OK |
Postal Code: | 730800662 |
Phone Number: | 4055271785 |
Fax Number: | 4055271084 |
NPI Enumeration Date: | 06/14/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 1728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |