Provider Demographics
NPI:1306539762
Name:SWANDER, AMELIA
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:
Last Name:SWANDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 W 400 S
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:IN
Mailing Address - Zip Code:46747-9728
Mailing Address - Country:US
Mailing Address - Phone:260-316-7999
Mailing Address - Fax:
Practice Address - Street 1:603 N WAYNE ST
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-1081
Practice Address - Country:US
Practice Address - Phone:260-668-8797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health