Provider Demographics
NPI:1376062521
Name:SWINDLE, YUL ANTELLE
Entity type:Individual
Prefix:
First Name:YUL
Middle Name:ANTELLE
Last Name:SWINDLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 ASPEN HILL CIR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-1724
Mailing Address - Country:US
Mailing Address - Phone:702-881-4065
Mailing Address - Fax:
Practice Address - Street 1:3065 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3352
Practice Address - Country:US
Practice Address - Phone:702-278-3622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty