Swenson, Mary Theresa

Swenson, Mary Theresa is an sole proprietor health care provider with primary practice located at 13750 Crosstown Dr Phase Ii Suite 207, Ham Lake MN 55304-2664. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Swenson, Mary Theresa can be contacted via phone (763) 413-6971.

Contact Information

Primary practice address
13750 Crosstown Dr Phase Ii Suite 207 Ham Lake MN 55304-2664
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 00808 Minnesota

Profile Details

NPI number 1093128233
LBN Legal business name Swenson, Mary Theresa
Credentials EDD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 5th, 2014
Last updated Dec 1st, 2014 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093128233 NPPES
Minnesota Other 01405 STATE LICENSE

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