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
Phone: (763) 413-6971
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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 12 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 | 1093128233 | NPPES |
| Minnesota | Other | 01405 | STATE LICENSE |
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