Nicole Antoinette Ware Spencer TLLP

NPI 1316141377 - Psychologist - 103T00000X

NPI Details
NPI 1316141377
Gender Female
Enumeration Date 06/13/2007
Last Updated 10/15/2015
Entity Type Individual
Active Over 9 years ago
Practice Location
1403 60TH STREET SOUTHEAST
KENTWOOD MI, 49508-7065, US
Phone (616) 719-4488
Fax (616) 719-4480
Business Location
1403 60TH STREET SOUTHEAST
KENTWOOD MI, 49508-7065, US
Phone (616) 719-4488
Fax (616) 532-3046
Toxanomy
Taxonomy Code 103T00000X
License State Michigan
License Number 6301013431
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According to our database, Nicole Antoinette Ware Spencer TLLP NPI is 1316141377, taxonomy code is 103T00000X and license number is 6301013431, license state is located at Michigan. Nicole Antoinette Ware Spencer TLLP physically located at 1403 60th Street Southeast, Kentwood MI, 49508-7065. NPI Number Nicole Antoinette Ware Spencer TLLP has the Individual type.

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1316141377 NPI number is provided on an as is basis without warranty of any kind. 1316141377 is maintained by the National Plan & Provider Enumeration System. The contents of Nicole Antoinette Ware Spencer TLLP are for informational purposes only.