Individual
PETER G. SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
48 N PLEASANT ST, SUITE 202, AMHERST, MA 01002-1738
(413) 253-1766
(413) 253-4089
Mailing address
99 LARKSPUR DR, AMHERST, MA 01002-3440
(413) 256-6733
(413) 253-4089
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4972
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0522503
MASS HEALTH PROVIDER NO.
MD
01
—
3529-9096
APA MEMBERSHIP NO.
MD
01
—
41071
NAT. REGISTRY NUMBER
MA
01
—
4972
STATE LICENSE NUMBER
MA
05
—
W04700
—
MA
Enumeration date
04/10/2007
Last updated
07/08/2007
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