Individual
CARRIE SWIDERSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1002 GEORGIA ST UNIT 104, HUNTINGTON BEACH, CA 92648-4364
(860) 417-9110
Mailing address
66 COLONIAL RD, WATERTOWN, CT 06795-3106
(860) 417-9110
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003660
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1307606
—
MA
Enumeration date
01/29/2007
Last updated
09/09/2019
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