Provider Demographics
NPI:1407239650
Name:SWANSON, ASHLEY KAY
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:KAY
Last Name:SWANSON
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 1:301 VETERANS PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-2899
Mailing Address - Country:US
Mailing Address - Phone:815-954-2026
Mailing Address - Fax:
Practice Address - Street 1:301 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-2899
Practice Address - Country:US
Practice Address - Phone:815-954-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst