Provider Demographics
NPI:1245540848
Name:SWARTZEL, KATHRYN DIANE
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:DIANE
Last Name:SWARTZEL
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 1:14934 STATE HIGHWAY 149
Mailing Address - Street 2:
Mailing Address - City:WEST FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:62896-4412
Mailing Address - Country:US
Mailing Address - Phone:574-276-6750
Mailing Address - Fax:
Practice Address - Street 1:14934 STATE HIGHWAY 149
Practice Address - Street 2:
Practice Address - City:WEST FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:62896-4412
Practice Address - Country:US
Practice Address - Phone:574-276-6750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist