Spencer, Teena Mellyn

Spencer, Teena Mellyn is an individual health care provider with primary practice located at 1835 Gilmore Ave Peace River Center, Lakeland FL 33805-3017. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Spencer, Teena Mellyn can be contacted via phone (863) 519-0575.

Contact Information

Primary practice address
1835 Gilmore Ave Peace River Center Lakeland FL 33805-3017
Phone: (863) 519-0575
Fax: (863) 582-9251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW9837 Florida

Profile Details

NPI number 1780783852
LBN Legal business name Spencer, Teena Mellyn
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Apr 20th, 2017 - about 7 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 1780783852 NPPES
Florida MEDICAID 759130600

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