Spencer, Jennifer Michael

Spencer, Jennifer Michael is an sole proprietor health care provider with primary practice located at 631 N College Ave , Bloomington IN 47404-3871. She recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as her primary health care specialty. Spencer, Jennifer Michael can be contacted via phone (812) 333-8474.

Contact Information

Primary practice address
631 N College Ave Bloomington IN 47404-3871
Phone: (812) 333-8474
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X 20041405A Indiana

Profile Details

NPI number 1003828880
LBN Legal business name Spencer, Jennifer Michael
Credentials PHD HSPP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 12th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003828880 NPPES
Indiana MEDICAID 200298330

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