Provider Demographics
NPI:1578767208
Name:SWOBODA, KAREN (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:
Last Name:SWOBODA
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-0040
Mailing Address - Country:US
Mailing Address - Phone:850-814-8941
Mailing Address - Fax:850-252-6027
Practice Address - Street 1:1219 VERMONT AVE
Practice Address - Street 2:
Practice Address - City:LYNN HAVEN
Practice Address - State:FL
Practice Address - Zip Code:32444-2162
Practice Address - Country:US
Practice Address - Phone:850-814-8941
Practice Address - Fax:850-252-6027
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2022-089103K00000X
TN553103TB0200X
FL1-05-2631103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst