Provider Demographics
NPI:1003130311
Name:SWIBLE, JESSICA LYNN (BA)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LYNN
Last Name:SWIBLE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PROSPECT ST
Mailing Address - Street 2:APT 2
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-3524
Mailing Address - Country:US
Mailing Address - Phone:603-969-1498
Mailing Address - Fax:
Practice Address - Street 1:9 CENTENNIAL DR
Practice Address - Street 2:SU 202
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-7939
Practice Address - Country:US
Practice Address - Phone:978-927-9260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor