Provider Information for 1093294860
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SIEDAH LADONNA SPENCER-ARDIS MA, LMFT
Sex: Female
NPI: 1093294860
Last Updated: 2025-01-06
Certification Date: 2025-01-06
Certification Date: 2025-01-06
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1093294860 | ||||||||||||
| Enumeration Date | 2018-08-12 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 26555 EVERGREEN RD STE 870 SOUTHFIELD, MI 48076-4239 United States Phone: 248-430-0594 | Fax: | ||||||||||||
| Primary Practice Address | 26555 EVERGREEN RD STE 870 SOUTHFIELD, MI 48076-4239 United States Phone: 248-430-0594 | Fax:800-868-0294 | ||||||||||||
| Secondary Practice Address(es) | 1000 S OLD WOODWARD AVE STE 108 330 TOWN CENTER DR STE 328 | ||||||||||||
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