Individual
MR. COLVILLE WASHINGTON SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS; CAP; RMHC
Contact information
Practice address
4612 N 56TH ST, TAMPA, FL 33610-7123
(813) 986-5966
(813) 986-9718
Mailing address
13618 PARK LAKE DR, SUITE. 101, TAMPA, FL 33618-3394
(813) 241-5029
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
766767100
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766767100
—
FL
Enumeration date
08/03/2006
Last updated
08/04/2015
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