Most Relevant Information
Provider Data
| NPI Number: | 1003828880 |
| Provider Name: | JENNIFER MICHAEL SPENCER PHD HSPP |
| Entity Type: | Individual |
| Taxonomy Code: | 103TC1900X |
| Specialty: | Psychologist |
| License Number: | 20041405A |
Most Important Dates
| Enumeration Date: | 08/12/2006 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
631 N COLLEGE AVE
BLOOMINGTON
IN
474043871
Practice Location Phone/Fax
| Phone: | 8123338474 |
| Fax: |
Provider Mailing Location
4956 N MUIRFIELD DR
BLOOMINGTON
IN
474041384
Provider Mailing Phone/Fax
| Phone: | 8123338474 |
| Fax: |