Provider Demographics
NPI:1316143084
Name:SPENCE, MARK D (MA)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:SPENCE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:25 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON UPPER FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:02464-1407
Mailing Address - Country:US
Mailing Address - Phone:508-996-8572
Mailing Address - Fax:508-991-8618
Practice Address - Street 1:1061 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6728
Practice Address - Country:US
Practice Address - Phone:508-996-8572
Practice Address - Fax:508-991-8618
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker