Individual
MS. SHANA LYNN SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FAODP
Contact information
Practice address
400 STODDARD RD., MEMPHIS, MI 48027
(810) 392-2167
Mailing address
8528 FRITH RD, COLUMBUS, MI 48063-1300
(810) 824-0604
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
S152765564736
MI
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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