Provider Demographics
NPI:1629280953
Name:SWANSON, DAWN J (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:J
Last Name:SWANSON
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 1ST AVE NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-2830
Mailing Address - Country:US
Mailing Address - Phone:507-298-2222
Mailing Address - Fax:507-298-2227
Practice Address - Street 1:300 1ST AVE NW
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2830
Practice Address - Country:US
Practice Address - Phone:507-298-2222
Practice Address - Fax:507-298-2227
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist