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Individual
MRS. MARY ELLEN SPENCER
Active
Individual
MRS. MARY ELLEN SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN68834
CA
Other
Enumeration date
01/15/2010
Last updated
01/15/2010
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