Provider Demographics
NPI:1851863385
Name:SWISHER, CHRISTIAN E (DT)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:E
Last Name:SWISHER
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3106 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-3945
Mailing Address - Country:US
Mailing Address - Phone:765-404-9937
Mailing Address - Fax:
Practice Address - Street 1:216 N 5TH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47901-2811
Practice Address - Country:US
Practice Address - Phone:765-423-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-21
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherNO OTHER IDENTIFIERS