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Individual

MRS. DIONNE L SPOONER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
28883 N 131ST DR, PEORIA, AZ 85383-4294
(701) 721-8978
Mailing address
28883 N 131ST DR, PEORIA, AZ 85383-4294
(701) 721-8978

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
3018
ND
1041C0700X
Clinical Social Worker
3018
ND
1041C0700X
Clinical Social Worker
Primary
LCSW-19395
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
130102
AZ
01
26353
BLUE SHIELD
ND
05
74019
ND
Enumeration date
12/26/2006
Last updated
06/04/2023
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