Doctor Name: | GLENDA SPENCER |
NPI Number: | 1518050541 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LAC |
License Number: | 1386 |
Business Practice Address: | 7448 68th Ave Ne Cando, ND - 583249485 |
Business Phone Number: | 7019682568 |
Business Fax Number: | 7019682552 |
Mailing Address: | Po Box 688, CANDO |
State: | ND |
Postal Code: | 583240688 |
Phone Number: | 7019682554 |
Fax Number: | 7019682574 |
NPI Enumeration Date: | 10/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 1386 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |