Provider Demographics
NPI:1326207689
Name:SPANN, MICHELE LYNN (BSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:LYNN
Last Name:SPANN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 FRANKLIN STREET
Mailing Address - Street 2:LAKE SHORE BEHAVIORAL HEALTH
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202
Mailing Address - Country:US
Mailing Address - Phone:716-842-0440
Mailing Address - Fax:716-842-4069
Practice Address - Street 1:254 FRANKLIN STREET
Practice Address - Street 2:NIAGARA SKILL CENTER
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202
Practice Address - Country:US
Practice Address - Phone:716-852-1117
Practice Address - Fax:716-852-1110
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker