Provider Demographics
NPI:1881063675
Name:SWIFT, JAIME
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:SWIFT
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 1:2825 56TH ST NW APT C
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3911
Mailing Address - Country:US
Mailing Address - Phone:507-434-4420
Mailing Address - Fax:507-433-7868
Practice Address - Street 1:1111 28TH ST NE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-6410
Practice Address - Country:US
Practice Address - Phone:507-434-4420
Practice Address - Fax:507-433-7868
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN173201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical