Provider Demographics
NPI:1225758857
Name:MCSWAIN, KATHRYN LEIGH
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEIGH
Last Name:MCSWAIN
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 1:13792 E 53RD ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-8579
Mailing Address - Country:US
Mailing Address - Phone:928-259-9077
Mailing Address - Fax:
Practice Address - Street 1:13792 E 53RD ST
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-8579
Practice Address - Country:US
Practice Address - Phone:928-259-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-27200225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist