Individual
MS. CYNTHIA FULLER SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
400 E MAIN ST, ALICE, TX 78332-4969
(361) 396-4029
(361) 396-4034
Mailing address
400 E MAIN ST, ALICE, TX 78332-4969
(361) 396-4029
(361) 396-4034
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT396
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014016
ANTHEM
ME
05
—
1225331366
—
ME
Enumeration date
12/15/2006
Last updated
09/30/2021
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