Provider Demographics
NPI:1801524475
Name:PIKE, SPENCER LAUREN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SPENCER
Middle Name:LAUREN
Last Name:PIKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5095 FAIRWAYS CIR APT 106
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-7434
Mailing Address - Country:US
Mailing Address - Phone:407-312-6640
Mailing Address - Fax:
Practice Address - Street 1:2965 20TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-3097
Practice Address - Country:US
Practice Address - Phone:772-567-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23281225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist