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1912442138
SPENCER T WARDLOW
BLOOMINGTON, IN
NPI
1912442138
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2016-12-23
Last Update Date
2017-12-01
Business Address
SPENCER T WARDLOW MSED
804 N COLLEGE AVE STE 100
BLOOMINGTON, IN 47404-3599
Phone number: 812-803-0663
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Mailing Address
SPENCER T WARDLOW MSED
804 N COLLEGE AVE STE 100
BLOOMINGTON, IN 47404-3599
Phone number: 812-803-0663
Copy
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