Individual
SPENCER T WARDLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSED
Contact information
Practice address
804 N COLLEGE AVE STE 100, BLOOMINGTON, IN 47404-3599
(812) 803-0663
(812) 213-8390
Mailing address
804 N COLLEGE AVE STE 100, BLOOMINGTON, IN 47404-3599
(812) 803-0663
(812) 213-8390
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/23/2016
Last updated
12/01/2017
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