Provider Demographics
NPI:1346578762
Name:SWANTON, JENNIFER CAROLINA
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CAROLINA
Last Name:SWANTON
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 1:9728 HAMMOCKS BLVD APT 204
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-1523
Mailing Address - Country:US
Mailing Address - Phone:786-271-2539
Mailing Address - Fax:
Practice Address - Street 1:9728 HAMMOCKS BLVD APT 204
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33196-1523
Practice Address - Country:US
Practice Address - Phone:786-271-2539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst