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Individual

MS. ANTONEAL NATOIS SWABY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
1223 GATEWAY DR STE 2G, MELBOURNE, FL 32901
(321) 361-5559
(321) 722-6033
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 361-5559

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY9139
FL
103TC0700X
Clinical Psychologist
PY9139
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HY340X
FL MEDICARE
FL
05
PENDING
FL
Enumeration date
10/07/2009
Last updated
03/19/2020
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