Healthcare Provider Details

I. General information

NPI: 1063688059
Provider Name (Legal Business Name): SANDRA-LEIGH SPRECKER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

449 DODGE HOLLOW RD
LEMPSTER NH
03605-3417
US

IV. Provider business mailing address

449 DODGE HOLLOW RD
LEMPSTER NH
03605-3417
US

V. Phone/Fax

Practice location:
  • Phone: 603-863-7292
  • Fax:
Mailing address:
  • Phone: 603-863-7292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number972
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number972
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number61047
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number972
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: