| Doctor Name: | MR. ALAN SPANG |
| NPI Number: | 1326383001 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CADC II |
| License Number: | 508 |
| Business Practice Address: | 101 Eaglefeather Dr Lame Deer, MT - 590430067 |
| Business Phone Number: | 4064776381 |
| Business Fax Number: | 4064776425 |
| Mailing Address: | P.o. Box67, 101 Eaglefeather Dr LAME DEER |
| State: | MT |
| Postal Code: | 59043 |
| Phone Number: | 4064776381 |
| Fax Number: | 4064776425 |
| NPI Enumeration Date: | 12/06/2012 |
| NPI Last Update Date: | 12/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 508 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |