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Individual

THOMAS DARRELL SPENCER JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2960 RODEO PARK DR W, SANTA FE, NM 87505-6351
(505) 986-9633
(505) 820-1209
Mailing address
157 NINE MILE RD, SANTA FE, NM 87508-8912
(505) 426-5750

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0169161
NM
101YM0800X
Mental Health Counselor
7453
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6014487
NC
Enumeration date
09/18/2009
Last updated
03/22/2024
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