Provider Demographics
NPI:1194607739
Name:SWIADER, DEBORAH GAIL (SAC-IT)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:GAIL
Last Name:SWIADER
Suffix:
Gender:F
Credentials:SAC-IT
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:GAIL
Other - Last Name:SWIADER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SAC-IT
Mailing Address - Street 1:PO BOX 815
Mailing Address - Street 2:
Mailing Address - City:LAC DU FLAMBEAU
Mailing Address - State:WI
Mailing Address - Zip Code:54538-0815
Mailing Address - Country:US
Mailing Address - Phone:715-588-1105
Mailing Address - Fax:715-388-0762
Practice Address - Street 1:PO BOX 815
Practice Address - Street 2:
Practice Address - City:LAC DU FLAMBEAU
Practice Address - State:WI
Practice Address - Zip Code:54538-0815
Practice Address - Country:US
Practice Address - Phone:715-588-1105
Practice Address - Fax:715-388-0762
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20830-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)