Provider Demographics
NPI:1578238465
Name:SPENCE, TAMARA (LMSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:SPENCE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-0129
Mailing Address - Country:US
Mailing Address - Phone:301-373-3065
Mailing Address - Fax:240-309-4131
Practice Address - Street 1:2670 CRAIN HWY STE 300
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2817
Practice Address - Country:US
Practice Address - Phone:301-373-3065
Practice Address - Fax:240-309-4131
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker