Provider Demographics
NPI:1114379351
Name:SWENSON, DEBORAH (BCBA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 FARRWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01835-8439
Mailing Address - Country:US
Mailing Address - Phone:978-521-3120
Mailing Address - Fax:
Practice Address - Street 1:212 FARRWOOD DR
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01835-8439
Practice Address - Country:US
Practice Address - Phone:978-521-3120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA847103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst