Provider Demographics
NPI:1447503115
Name:JOSEPH E. SWITRAS, PH.D., PA
Entity type:Organization
Organization Name:JOSEPH E. SWITRAS, PH.D., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ELLSWORTH
Authorized Official - Last Name:SWITRAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:507-235-5651
Mailing Address - Street 1:208 W 2ND ST
Mailing Address - Street 2:SUITE 116
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-1843
Mailing Address - Country:US
Mailing Address - Phone:507-235-5651
Mailing Address - Fax:507-235-5651
Practice Address - Street 1:208 W 2ND ST
Practice Address - Street 2:SUITE 116
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-1843
Practice Address - Country:US
Practice Address - Phone:507-235-5651
Practice Address - Fax:507-235-5651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2765103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty