Provider Demographics
NPI:1467578484
Name:SWANSON, APRIL R
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:R
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 1:731 S LANDRUM ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:MO
Mailing Address - Zip Code:65712-1723
Mailing Address - Country:US
Mailing Address - Phone:417-466-7573
Mailing Address - Fax:417-461-5794
Practice Address - Street 1:SCHOOL DIST MT VERNON
Practice Address - Street 2:731 S LANDRUM ST
Practice Address - City:MOUNT VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712-1723
Practice Address - Country:US
Practice Address - Phone:417-466-7573
Practice Address - Fax:417-461-5794
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001032998225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist