Organization
SPENCER TASCH CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITA SPENCER (OWNER)
(715) 210-9284
Entity
Organization
Contact information
Practice address
800 WISCONSIN ST STE 420, EAU CLAIRE, WI 54703-3588
(715) 210-9284
Mailing address
800 WISCONSIN ST STE 420, EAU CLAIRE, WI 54703-3588
(715) 210-9284
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1231-125
WI
101Y00000X
Counselor
130012-121
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467985507
—
WI
05
—
1508305269
—
WI
Enumeration date
02/20/2018
Last updated
04/02/2018
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