Provider Demographics
NPI:1528505732
Name:SWANBERG, ANNE (AUD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:SWANBERG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 BASELINE RD
Mailing Address - Street 2:SUITE E-108
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-2699
Mailing Address - Country:US
Mailing Address - Phone:303-499-3900
Mailing Address - Fax:
Practice Address - Street 1:4800 BASELINE RD
Practice Address - Street 2:SUITE E-108
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-2699
Practice Address - Country:US
Practice Address - Phone:303-499-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO840231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO840OtherAUDIOLOGIST LICENSE