Individual
BETTY SHARON SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
(928) 697-4189
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-2368
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
060012
—
AZ
Enumeration date
10/01/2007
Last updated
12/15/2016
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