Provider Demographics
NPI:1902364169
Name:SPENA, LUCY ANNE (MS ED)
Entity Type:Individual
Prefix:MISS
First Name:LUCY
Middle Name:ANNE
Last Name:SPENA
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 W END AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3870
Mailing Address - Country:US
Mailing Address - Phone:607-242-7370
Mailing Address - Fax:
Practice Address - Street 1:136 W END AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-3870
Practice Address - Country:US
Practice Address - Phone:607-242-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency