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General NPI Number Information
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NPI Number | 1396412474
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Entity Type | Individual
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Provider Name | MAKIYA SPENCER
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Gender | Female
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Dates
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Enumeration Date | 08/25/2021
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 29228 US HIGHWAY 19 N
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City | CLEARWATER
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State | FL
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Zip | 33761-2101
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Country | US
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Telephone | 727-351-4191
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Fax | 727-314-7288
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Provider Business Mailing Address
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Address Line | 300 INTERNATIONAL PKWY STE 200
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City | LAKE MARY
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State | FL
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Zip | 32746-5028
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Country | US
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Telephone | 407-915-7729
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Fax | 407-588-6294
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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