Provider Demographics
NPI:1902003163
Name:SPENCE, MARGIE MARIE (LM, CPM)
Entity Type:Individual
Prefix:MRS
First Name:MARGIE
Middle Name:MARIE
Last Name:SPENCE
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6864
Mailing Address - Country:US
Mailing Address - Phone:817-905-2850
Mailing Address - Fax:817-431-3592
Practice Address - Street 1:2605 FLORENCE RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-6864
Practice Address - Country:US
Practice Address - Phone:817-905-2850
Practice Address - Fax:817-431-3592
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96128175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay