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Individual
LARRY ANTHONY SPENCE
Active
Individual
LARRY ANTHONY SPENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
4152-120
WI
104100000X
Social Worker
4152-120
WI
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40921600
—
WI
Enumeration date
12/17/2008
Last updated
12/17/2008
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