Provider Demographics
NPI:1770182305
Name:SPATZ, EMILY (LMFT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SPATZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3901 SHADY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6205
Mailing Address - Country:US
Mailing Address - Phone:954-547-9928
Mailing Address - Fax:754-400-9113
Practice Address - Street 1:6201 SW 180TH TER
Practice Address - Street 2:
Practice Address - City:SOUTHWEST RANCHES
Practice Address - State:FL
Practice Address - Zip Code:33331-1611
Practice Address - Country:US
Practice Address - Phone:954-547-9928
Practice Address - Fax:754-400-9113
Is Sole Proprietor?:No
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3916106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist