Individual
SHAY LYNN SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS QMHP
Contact information
Practice address
408 E VINE ST, VIENNA, IL 62995-1612
(618) 658-2611
(618) 658-2501
Mailing address
9230 MANEESE LN, GOREVILLE, IL 62939-3612
(618) 713-2256
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/07/2008
Last updated
07/17/2015
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