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General NPI Number Information
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NPI Number | 1104710870
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Entity Type | Individual
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Provider Name | CONYA SPENCER LAC
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Gender | Female
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Dates
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Enumeration Date | 06/05/2025
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 628 W BROADWAY ST STE 300
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5547
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Country | US
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Telephone | 501-372-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 9601 WESTLAKE CIR
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City | SHERWOOD
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State | AR
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Zip | 72120-4083
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Country | US
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Telephone | 501-804-0758
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Fax |
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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