MEDICARE: SPENCER DE RANZO

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	:	1639001704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SPENCER DE RANZO

Provider Business Mailing Address
First Line	:	550 STEPHENSON HWY
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 STEPHENSON HWY
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-1109
Country	:	US
Telephone Number	:	248-585-3239
Fax Number	:

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ SPENCER DE RANZO ” Practice Location

Language	Start Address	Practice Location

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