Provider Demographics
NPI:1861685729
Name:SPENCER, MARSHA L S (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:L S
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 1:6818 S 42ND ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-5206
Mailing Address - Country:US
Mailing Address - Phone:480-730-7287
Mailing Address - Fax:
Practice Address - Street 1:6818 S 42ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5206
Practice Address - Country:US
Practice Address - Phone:480-730-7287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3900899103TS0200X
AZ3998103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool