Provider Demographics
NPI:1043887813
Name:SWEARINGEN, KILEY NOELLE
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:NOELLE
Last Name:SWEARINGEN
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 1:10050 LEGACY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-6752
Mailing Address - Country:US
Mailing Address - Phone:214-494-4677
Mailing Address - Fax:
Practice Address - Street 1:10050 LEGACY DR STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-6752
Practice Address - Country:US
Practice Address - Phone:214-494-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist