Provider Demographics
NPI:1861858755
Name:SWIFT, VANILDA
Entity Type:Individual
Prefix:MRS
First Name:VANILDA
Middle Name:
Last Name:SWIFT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 BOG VIEW RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-7129
Mailing Address - Country:US
Mailing Address - Phone:774-773-9450
Mailing Address - Fax:774-773-9450
Practice Address - Street 1:29 BOG VIEW RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7129
Practice Address - Country:US
Practice Address - Phone:774-773-9450
Practice Address - Fax:774-773-9450
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst