Provider Demographics
NPI:1407049950
Name:MARJEAN SPAYER PHD PC
Entity Type:Organization
Organization Name:MARJEAN SPAYER PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARJEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPAYER
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:505-521-4800
Mailing Address - Street 1:PO BOX 13242
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88013-3242
Mailing Address - Country:US
Mailing Address - Phone:505-521-4800
Mailing Address - Fax:505-521-6399
Practice Address - Street 1:3003 HILLRISE DR
Practice Address - Street 2:SUITE B-2
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4897
Practice Address - Country:US
Practice Address - Phone:505-521-4800
Practice Address - Fax:505-521-6399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-18
Last Update Date:2007-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM577103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty