Individual
ANDREA JO SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS QMHP
Contact information
Practice address
6415 STANLEY, ILC ENTERPRISES, BERWYN, IL 60402
(708) 788-0511
(708) 788-0831
Mailing address
2457 N TALMAN, CHICAGO, IL 60647
(773) 486-5260
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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