Provider Demographics
NPI:1508565961
Name:SPENCER, RONAE (ALC)
Entity Type:Individual
Prefix:
First Name:RONAE
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 MOUNTAIN RIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:MILLBROOK
Mailing Address - State:AL
Mailing Address - Zip Code:36054
Mailing Address - Country:US
Mailing Address - Phone:334-595-3622
Mailing Address - Fax:
Practice Address - Street 1:2400 PRESIDENTS DRIVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116
Practice Address - Country:US
Practice Address - Phone:334-544-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health