Provider Demographics
NPI:1699981100
Name:SWINDALL, DAVID E (MDIV,LMFT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:E
Last Name:SWINDALL
Suffix:
Gender:M
Credentials:MDIV,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5580 PARK BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3328
Mailing Address - Country:US
Mailing Address - Phone:727-544-9305
Mailing Address - Fax:
Practice Address - Street 1:5580 PARK BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3328
Practice Address - Country:US
Practice Address - Phone:727-544-9305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT885106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist