Provider Information for 1689770455
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Mr. MATTHEW SPENCER LCSW
Sex: Male
NPI: 1689770455
Last Updated: 2024-11-28
Certification Date: 2024-11-28
Certification Date: 2024-11-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1689770455 | ||||||||
| Enumeration Date | 2006-09-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2600 FAIRWAY DR INDEPENDENCE, KS 67301-1612 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 3500 E FRANK PHILLIPS BLVD BARTLESVILLE, OK 74006-2411 United States Phone: 918-331-1112 | Fax: | ||||||||
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