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General NPI Number Information
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NPI Number | 1124380480
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Entity Type | Individual
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Provider Name | ROBERTA NICOLE SPENCER MS SLP
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Gender | Female
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 2725 CROMPOND RD YORKTOWN CSD
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City | YORKTOWN
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State | NY
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Zip | 10598
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Country | US
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Telephone | 914-243-8000
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Fax | 914-245-5566
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Provider Business Mailing Address
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Address Line | 23 DEER RUN PO BOX 54
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City | NEW FAIRFIELD
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State | CT
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Zip | 06812
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Country | US
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Telephone | 914-879-2919
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Fax | 914-245-5566
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TSSLD1155734
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 023223
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License Number State | NY
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