Individual
COLEEN SWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
301 FOX HORN DR, WATERFORD, WI 53185-4005
(262) 758-0230
Mailing address
301 FOX HORN DR, WATERFORD, WI 53185-4005
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2272-120
WI
Other
Enumeration date
09/09/2009
Last updated
09/09/2009
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