Provider Information for 1992292981
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BONNIE KATHRYN SPICER LPC-MHSP
Sex: Female
NPI: 1992292981
Last Updated: 2024-05-23
Certification Date: 2024-05-23
Certification Date: 2024-05-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1992292981 | ||||||||
| Enumeration Date | 2018-04-16 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 224 STEAM MILL FERRY RD JACKSON, TN 38301-1912 United States Phone: 731-660-6060 | Fax: | ||||||||
| Primary Practice Address | 165 BELLMEADE DRIVE JACKSON, TN 38301-2202 United States Phone: 731-803-1447 | Fax: | ||||||||
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