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Individual

MIKAELA SPENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 732-7419
Mailing address
24 OLD POST RD, WORTHINGTON, MA 01098-9772
(413) 822-3906

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2268677
MA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN2268677
MA

Other

Enumeration date
09/19/2014
Last updated
07/28/2023
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