Provider Demographics
NPI:1003525130
Name:SPENCE, LAIMARI MICHELLE
Entity Type:Individual
Prefix:
First Name:LAIMARI
Middle Name:MICHELLE
Last Name:SPENCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5158 LONGBRANCH LN APT G
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:OH
Mailing Address - Zip Code:43213-3264
Mailing Address - Country:US
Mailing Address - Phone:380-900-1336
Mailing Address - Fax:
Practice Address - Street 1:5158 LONGBRANCH LN APT G
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:OH
Practice Address - Zip Code:43213-3264
Practice Address - Country:US
Practice Address - Phone:380-900-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide