Individual
MRS. DOROTHY ANN SPENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMFT
Contact information
Practice address
136 S ACADEMY AVE, EAGLE, ID 83616-6541
(208) 859-7256
(208) 939-9110
Mailing address
136 S ACADEMY AVE, EAGLE, ID 83616-6541
(208) 859-7256
(208) 939-9110
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-17
ID
106H00000X
Marriage & Family Therapist
LMFT 2637
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010034083
BLUE SHIELD
ID
01
—
A852428
VALUE OPTIONS
—
01
—
Q4806
BC/BS
ID
Enumeration date
05/17/2006
Last updated
05/01/2023
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