Provider Demographics
NPI:1710165857
Name:SPENCER, ELINOR A (OTL)
Entity Type:Individual
Prefix:MS
First Name:ELINOR
Middle Name:A
Last Name:SPENCER
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:E
Other - Last Name:SPENCER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:587 NO DEER ISLE RD
Mailing Address - Street 2:
Mailing Address - City:DEER ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04627
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ROUTE 15 587 NO DEER ISLE RD
Practice Address - Street 2:ISLAND NURSING HOME
Practice Address - City:DEER ISLE
Practice Address - State:ME
Practice Address - Zip Code:04627
Practice Address - Country:US
Practice Address - Phone:207-348-2351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME14225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist