Individual
KATHRYN N SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, PMHNP-BC
Contact information
Practice address
300 CHURCH ST STE 204, WALLINGFORD, CT 06492-2253
(203) 314-0940
Mailing address
300 CHURCH ST, STE 205, YALESVILLE, CT 06492-2253
(203) 314-0940
(860) 530-9567
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
7851
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
7851
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008083045
—
CT
Enumeration date
09/14/2018
Last updated
09/08/2023
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