Individual
SHANNON SWENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
117 W JAMES ST, PAYNESVILLE, MN 56362-1216
(320) 243-3379
Mailing address
PO BOX 3, PAYNESVILLE, MN 56362-0003
(320) 243-3379
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
TEMP
MN
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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