Individual
MRS. VERNELLE LOUISE SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
3111 E BROADWAY AVE, BISMARCK, ND 58501-5085
(701) 334-6242
Mailing address
3111 E BROADWAY AVE, BISMARCK, ND 58501-5085
(701) 334-6242
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1472475
—
ND
Enumeration date
12/17/2021
Last updated
12/17/2021
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