Individual
MS. SARA J SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
9200 WEST WISCONSIN AVE, FROEDTERT & MED COLLEGE CLIN - WEST, MILWAUKEE, WI 53226
(414) 805-3666
Mailing address
9200 W WISCONSIN AVE, FROEDTERT & MED COLLEGE CLIN - WEST, MILWAUKEE, WI 53226-3522
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1507
WI
103TC0700X
Clinical Psychologist
Primary
1507
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000136E
HUMANA
—
05
—
1841241528
—
WI
05
—
39103600
—
WI
Enumeration date
05/15/2006
Last updated
09/17/2019
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