Individual
JOANIE SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
25 AMANDA DR, JESUP, GA 31545-7929
(912) 530-7954
Mailing address
25 AMANDA DR, JESUP, GA 31545-7929
(912) 530-7954
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
006791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006791
LICENSE
GA
Enumeration date
08/03/2010
Last updated
10/05/2011
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