Provider Demographics
NPI:1134485717
Name:SPENCER, EMILY (BCABA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 STONEYCREEK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4146
Mailing Address - Country:US
Mailing Address - Phone:804-380-2741
Mailing Address - Fax:
Practice Address - Street 1:1619 STONEYCREEK DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4146
Practice Address - Country:US
Practice Address - Phone:804-380-2741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-08
Last Update Date:2012-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst