Provider Demographics
NPI:1558608257
Name:SPEARS, DATRIONA (MSW, QP)
Entity Type:Individual
Prefix:
First Name:DATRIONA
Middle Name:
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MSW, QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 CALDWELL ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-1547
Mailing Address - Country:US
Mailing Address - Phone:336-491-3380
Mailing Address - Fax:
Practice Address - Street 1:7900 TRIAD CENTER DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9073
Practice Address - Country:US
Practice Address - Phone:336-931-1800
Practice Address - Fax:336-931-1801
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health