Provider Demographics
NPI:1992340046
Name:SPENCER, ZYNIA (MS, RMFTI)
Entity type:Individual
Prefix:
First Name:ZYNIA
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MS, RMFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 HOBSON ST APT 104
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-7518
Mailing Address - Country:US
Mailing Address - Phone:407-765-0086
Mailing Address - Fax:
Practice Address - Street 1:345 W. OAK ST.
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:407-518-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT2429106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty