Provider Demographics
NPI:1942440938
Name:SWOMIA, MANDY CLAIRE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MANDY
Middle Name:CLAIRE
Last Name:SWOMIA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5266 THORSON RD
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9751
Mailing Address - Country:US
Mailing Address - Phone:608-834-1716
Mailing Address - Fax:
Practice Address - Street 1:718 JUPITER DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53718-2950
Practice Address - Country:US
Practice Address - Phone:608-663-8859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3447-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist