Individual
ELISE SWAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPMT
Contact information
Practice address
1401 AVOCADO AVE, STE. 810, NEWPORT BEACH, CA 92660-7720
(949) 854-5555
Mailing address
48 MIRADOR, IRVINE, CA 92612
(949) 854-5555
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
BT30007599
CA
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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