Individual
JOHNATHAN LEE SPENCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PRSS
Contact information
Practice address
200 UPPER KANAWHA VALLEY WAY, CABIN CREEK, WV 25035
(681) 265-5090
Mailing address
5198 WHITMAN CREEK RD, LOGAN, WV 25601-8802
(304) 785-2220
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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