Provider Demographics
NPI:1801597174
Name:SPENCER, KATHY FRENTON (LSW)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:FRENTON
Last Name:SPENCER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 WEST ST
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1686
Mailing Address - Country:US
Mailing Address - Phone:937-510-2478
Mailing Address - Fax:
Practice Address - Street 1:901 WEST ST
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-1686
Practice Address - Country:US
Practice Address - Phone:937-510-2478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker