Individual
LARRY ANTHONY SPENCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5626 N 91ST ST STE 301, MILWAUKEE, WI 53225-2745
(414) 461-1088
(414) 461-1049
Mailing address
5626 N 91ST ST STE 301, MILWAUKEE, WI 53225-2745
(414) 461-1088
(414) 461-1049
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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