Swanson, Randy Judd
Swanson, Randy Judd is an individual health care provider with primary practice located at 6040 Earle Brown Dr , Brooklyn Center MN 55430-2514. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Swanson, Randy Judd can be contacted via phone (952) 666-5896.Contact Information
Primary practice address
6040 Earle Brown Dr
Brooklyn Center MN 55430-2514
Phone: (952) 666-5896
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2758 | Minnesota |
Profile Details
NPI number | 1528155140 |
---|---|
LBN Legal business name | Swanson, Randy Judd |
Credentials | LICSW |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 6th, 2006 |
Last updated | Nov 16th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1528155140 | NPPES |
Minnesota | MEDICAID | 950557100 |
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