Provider Demographics
NPI:1679631667
Name:SPENCER, DEBORAH DOWNS (PHD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:DOWNS
Last Name:SPENCER
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 1:1901 60TH TER NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1723
Mailing Address - Country:US
Mailing Address - Phone:727-481-8533
Mailing Address - Fax:
Practice Address - Street 1:425 22ND AVE N
Practice Address - Street 2:SUITE B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-4345
Practice Address - Country:US
Practice Address - Phone:727-481-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY00005839103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54669Medicare ID - Type UnspecifiedPROVIDER NUMBER