Organization
EMOTIONAL & BEHAVIORAL HEALTH PSYCHOLOGY SWISTUN PHD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIKA J SWISTUN PHD (CEO)
(312) 375-1827
Entity
Organization
Contact information
Practice address
9850 GENESEE AVE STE 130, LA JOLLA, CA 92037-1206
(312) 375-1827
Mailing address
9850 GENESEE AVE STE 130, LA JOLLA, CA 92037-1206
(312) 375-1827
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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