Provider Demographics
NPI:1588060552
Name:SPENCER, DAVID (MS, BCBA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:SPENCER
Suffix:
Gender:M
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 GALT ST
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1613
Mailing Address - Country:US
Mailing Address - Phone:502-475-8012
Mailing Address - Fax:
Practice Address - Street 1:315 GALT ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1613
Practice Address - Country:US
Practice Address - Phone:502-475-8012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst