Provider Demographics
NPI:1265142459
Name:SWOGER, CATHRYN
Entity type:Individual
Prefix:
First Name:CATHRYN
Middle Name:
Last Name:SWOGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHRYN
Other - Middle Name:
Other - Last Name:WEISS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7390 S PACIFIC WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85747-9558
Mailing Address - Country:US
Mailing Address - Phone:516-946-5029
Mailing Address - Fax:
Practice Address - Street 1:7390 S PACIFIC WILLOW DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85747-9558
Practice Address - Country:US
Practice Address - Phone:516-946-5029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-29
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1-22-62310103K00000X
CA1-22-62310103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst