| Doctor Name: | DR. LEROY SPANIOL |
| NPI Number: | 1821235920 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 1959 |
| Business Practice Address: | 405 Old Kings Hwy Wellfleet, MA - 026678012 |
| Business Phone Number: | 5083492475 |
| Business Fax Number: | |
| Mailing Address: | 405 Old Kings Hwy, WELLFLEET |
| State: | MA |
| Postal Code: | 026678012 |
| Phone Number: | 5083492475 |
| Fax Number: | |
| NPI Enumeration Date: | 01/11/2009 |
| NPI Last Update Date: | 01/11/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TR0400X |
| License Number: | 1959 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |