Provider Demographics
NPI:1740776855
Name:SWAMINATHAN, DIVYA (MS)
Entity Type:Individual
Prefix:
First Name:DIVYA
Middle Name:
Last Name:SWAMINATHAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 HEMENWAY ST APT 9
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-2934
Mailing Address - Country:US
Mailing Address - Phone:352-239-0912
Mailing Address - Fax:
Practice Address - Street 1:2000 VAN NESS AVE STE 702
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-3015
Practice Address - Country:US
Practice Address - Phone:415-563-6541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist