Provider Demographics
NPI:1457026437
Name:SWANBERG, KATHRYN GRAYCE (MA CF-SLP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:GRAYCE
Last Name:SWANBERG
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 W STANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2572
Mailing Address - Country:US
Mailing Address - Phone:937-369-5011
Mailing Address - Fax:
Practice Address - Street 1:921 MYSTIC LN
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2254
Practice Address - Country:US
Practice Address - Phone:937-332-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist