Individual
DR. THOMAS J SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY D
Contact information
Practice address
2625 FAIRWAY DR, SUITE E, FULTON, MO 65251-3936
(573) 642-1775
(573) 642-1850
Mailing address
2625 FAIRWAY DR, SUITE E, FULTON, MO 65251-3936
(573) 642-1775
(573) 642-1850
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2003030098
MO
103TC0700X
Clinical Psychologist
2003030098
MO
103TF0200X
Forensic Psychologist
2003030098
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
498312305
—
MO
Enumeration date
01/16/2007
Last updated
03/28/2017
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