Provider Demographics
NPI:1427600360
Name:SWIFT, MONICA (OT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:SPECULATOR
Mailing Address - State:NY
Mailing Address - Zip Code:12164-0277
Mailing Address - Country:US
Mailing Address - Phone:518-332-1528
Mailing Address - Fax:
Practice Address - Street 1:120 ELM LAKE ROAD
Practice Address - Street 2:
Practice Address - City:SPECULATOR
Practice Address - State:NY
Practice Address - Zip Code:12164
Practice Address - Country:US
Practice Address - Phone:518-548-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023721-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist