Provider Demographics
NPI:1437147204
Name:SWILLEY, CHRISTINA L (OT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:SWILLEY
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 1:134 HOSPITAL DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2819
Mailing Address - Country:US
Mailing Address - Phone:337-261-5151
Mailing Address - Fax:
Practice Address - Street 1:134 HOSPITAL DR
Practice Address - Street 2:SUITE 109
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2819
Practice Address - Country:US
Practice Address - Phone:337-261-5151
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTTZ11197225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4C210Medicare ID - Type Unspecified