Provider Demographics
NPI:1023570934
Name:SWAIN, ANDREA CREE
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:CREE
Last Name:SWAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-6342
Mailing Address - Country:US
Mailing Address - Phone:269-425-4279
Mailing Address - Fax:
Practice Address - Street 1:1714 COMFORT ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48915-1511
Practice Address - Country:US
Practice Address - Phone:616-634-2923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician