Individual
MS. DANIELLE SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
1109 CARTER ST STE 10, VIDALIA, LA 71373-3227
(318) 336-4700
(318) 336-4777
Mailing address
1109 CARTER ST STE 10, VIDALIA, LA 71373-3227
(318) 336-4700
(318) 336-4777
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PLC9430
LA
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
640897031
—
LA
Enumeration date
05/21/2020
Last updated
03/29/2023
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