Doctor Name: | DR. JEFFREY SPENCER |
NPI Number: | 1144215641 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ED.D, LPC |
License Number: | PC003406 |
Business Practice Address: | 120 S Highland St Lock Haven, PA - 177452812 |
Business Phone Number: | 5707487173 |
Business Fax Number: | 5707485717 |
Mailing Address: | 120 S Highland St, LOCK HAVEN |
State: | PA |
Postal Code: | 177452812 |
Phone Number: | 5707487173 |
Fax Number: | 5707485717 |
NPI Enumeration Date: | 09/12/2005 |
NPI Last Update Date: | 09/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC003406 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |