Healthcare Provider Details

I. General information

NPI: 1639579170
Provider Name (Legal Business Name): TAMRA MILLER-SPENCE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 W LIBERTY ST STE 279
LANCASTER PA
17603-2748
US

IV. Provider business mailing address

313 W LIBERTY ST STE 279
LANCASTER PA
17603-2748
US

V. Phone/Fax

Practice location:
  • Phone: 717-748-5828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC010031
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH002441
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: