Organization
SPENCER PSYCHOLOGY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL STEPHEN SPENCER PHD (PSYCHOLOGIST)
(715) 533-0812
Entity
Organization
Contact information
Practice address
40154 US HIGHWAY 53, WHITEHALL, WI 54773-9329
(715) 533-0812
(888) 823-3671
Mailing address
40154 US HIGHWAY 53, WHITEHALL, WI 54773-9329
(715) 533-0812
(888) 823-3671
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2573-057
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
620450011
MEDICARE PTAN
WI
Enumeration date
06/25/2013
Last updated
06/25/2013
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