Provider Demographics
NPI:1356603930
Name:SPENDLOVE, REX ALAN (LPC)
Entity type:Individual
Prefix:MR
First Name:REX
Middle Name:ALAN
Last Name:SPENDLOVE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 N 200 E
Mailing Address - Street 2:
Mailing Address - City:NORTH LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-1913
Mailing Address - Country:US
Mailing Address - Phone:435-890-5538
Mailing Address - Fax:435-753-7654
Practice Address - Street 1:1635 N 200 E
Practice Address - Street 2:
Practice Address - City:NORTH LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-1913
Practice Address - Country:US
Practice Address - Phone:435-890-5538
Practice Address - Fax:435-753-7654
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7788192-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional