Provider Demographics
NPI:1821238791
Name:SWAGLER, MICHELLE A (PHD)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:SWAGLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 S MILLEDGE AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-6723
Mailing Address - Country:US
Mailing Address - Phone:706-548-6744
Mailing Address - Fax:706-534-3987
Practice Address - Street 1:1150 S MILLEDGE AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-6723
Practice Address - Country:US
Practice Address - Phone:706-548-6744
Practice Address - Fax:706-548-6744
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002883103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist