| NPI | 1063604403 |
|---|---|
| Former Name | JOHN SWANGO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA 002917) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA 38618) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2008-05-16 |