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General NPI Number Information
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NPI Number | 1053361089
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Entity Type | Individual
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Provider Name | CYNTHIA SPENCER DO
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 812 E JOLLY RD STE G14
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City | LANSING
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State | MI
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Zip | 48910-6818
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Country | US
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Telephone | 517-346-8270
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Fax | 517-346-8291
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Provider Business Mailing Address
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Address Line | 812 E JOLLY RD STE 210
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City | LANSING
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State | MI
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Zip | 48910-6818
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Country | US
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Telephone | 517-346-8410
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Fax | 517-346-8291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101012948
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License Number State | MI
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