Provider Demographics
NPI:1588139158
Name:SWAGGARD, ONDEA
Entity type:Individual
Prefix:
First Name:ONDEA
Middle Name:
Last Name:SWAGGARD
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 1:122 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:PAGELAND
Mailing Address - State:SC
Mailing Address - Zip Code:29728-1925
Mailing Address - Country:US
Mailing Address - Phone:803-370-1112
Mailing Address - Fax:
Practice Address - Street 1:122 N PEARL ST
Practice Address - Street 2:
Practice Address - City:PAGELAND
Practice Address - State:SC
Practice Address - Zip Code:29728-1925
Practice Address - Country:US
Practice Address - Phone:803-370-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health