Provider Demographics
NPI:1487833364
Name:SWIER, LYNNE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:
Last Name:SWIER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N MESA VERDE AVE
Mailing Address - Street 2:
Mailing Address - City:AZTEC
Mailing Address - State:NM
Mailing Address - Zip Code:87410-1934
Mailing Address - Country:US
Mailing Address - Phone:505-334-3426
Mailing Address - Fax:
Practice Address - Street 1:1607 W AZTEC BLVD
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-1805
Practice Address - Country:US
Practice Address - Phone:505-334-3695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM055225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist