Basic Information
| Provider Information | |||||||||
| NPI: | 1760438071 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SPENCE | ||||||||
| FirstName: | KAY | ||||||||
| MiddleName: | HARMON | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1041 HIGHLAND CIR | ||||||||
| Address2: | STE 36 | ||||||||
| City: | MOUNTAIN HOME | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726533267 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704251041 | ||||||||
| FaxNumber: | 8704251049 | ||||||||
| Practice Location | |||||||||
| Address1: | 4508 STADIUM BLVD | ||||||||
| Address2: | |||||||||
| City: | JONESBORO | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724049675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709336886 | ||||||||
| FaxNumber: | 8709339395 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 01/17/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 2031C | AR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.