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MS. SARA J SWANSON PHD

Clinical Neuropsychologist

Milwaukee, Wisconsin

Provider NPI: 1841241528

Provider Information:
MS. SARA J SWANSON PHD
Gender: F
Not Sole Proprietor

Practice Location:
9200 WEST WISCONSIN AVE FROEDTERT & MED COLLEGE CLIN - WEST MILWAUKEE, WI 53226 US
Tel: 414-805-3666  Fax: --

Business Mailing Address:
9200 W WISCONSIN AVE FROEDTERT & MED COLLEGE CLIN - WEST MILWAUKEE, WI 53226 US
Tel: --  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
WI1507
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
WI1507

Other Provider Identifiers:

IssuerNumberStateType
HUMANA002000136E01
39103600WI05
1841241528WI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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