Provider Demographics
NPI:1518383090
Name:SPICER, VERONIKA KARPENKO (PHD)
Entity Type:Individual
Prefix:
First Name:VERONIKA
Middle Name:KARPENKO
Last Name:SPICER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 W SOUTH BOUNDARY ST,
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551
Mailing Address - Country:US
Mailing Address - Phone:419-874-3201
Mailing Address - Fax:419-874-1989
Practice Address - Street 1:836 W SOUTH BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-5640
Practice Address - Country:US
Practice Address - Phone:419-874-3201
Practice Address - Fax:419-874-1989
Is Sole Proprietor?:No
Enumeration Date:2014-03-08
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7292103T00000X, 103TB0200X, 103TC0700X
OK1200103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral