MEDICARE: AMBER LYNN SPICER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1558979492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LYNN SPICER

Provider Business Mailing Address
First Line	:	2007 BELLINGHAM ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-1880
Country	:	US
Telephone Number	:	734-934-0312
Fax Number	:

Provider Business Practice Location Address
First Line	:	2007 BELLINGHAM ST
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-1880
Country	:	US
Telephone Number	:	734-934-0312
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2020
Last Update Date	:	07/16/2020

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Directions to “ AMBER LYNN SPICER ” Practice Location

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