Individual
LISA SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERT PEER SUP SPEC
Contact information
Practice address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 747-4600
Mailing address
316 2ND AVE W, WILLISTON, ND 58801-5218
(701) 747-4600
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
180
ND
Other
Enumeration date
07/20/2021
Last updated
07/20/2021
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