Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 44SC00660400 | NJ |
NPI | 1982729059 |
---|---|
Provider Name | Tammy E. Swank |
First Address | Barnegat, NJ 08005-2469 |
Second Address | Forked River, NJ 08731-4300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |