Provider Demographics
NPI:1245246370
Name:SPENCE, CYNTHIA D
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:D
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 1:1430 OLIVE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-2303
Mailing Address - Country:US
Mailing Address - Phone:314-206-3902
Mailing Address - Fax:
Practice Address - Street 1:3165 MCKELVEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2550
Practice Address - Country:US
Practice Address - Phone:314-206-3900
Practice Address - Fax:314-206-3992
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker