Provider Demographics
NPI:1023276904
Name:SPITZER, VICKIE L (PSYD)
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:L
Last Name:SPITZER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15014 W WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-8955
Mailing Address - Country:US
Mailing Address - Phone:623-363-7451
Mailing Address - Fax:
Practice Address - Street 1:501 E PLAZA CIR
Practice Address - Street 2:STE B
Practice Address - City:LITCHFIELD PARK
Practice Address - State:AZ
Practice Address - Zip Code:85340-4998
Practice Address - Country:US
Practice Address - Phone:623-201-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4710103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist