Provider Demographics
NPI:1861837056
Name:SPENCE, SCOTT WOODWARD (MA-CCC-A)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:WOODWARD
Last Name:SPENCE
Suffix:
Gender:M
Credentials:MA-CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 COSHOCTON AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1900
Mailing Address - Country:US
Mailing Address - Phone:740-392-4572
Mailing Address - Fax:
Practice Address - Street 1:809 COSHOCTON AVE
Practice Address - Street 2:SUITE F
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1900
Practice Address - Country:US
Practice Address - Phone:740-392-4572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-02
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-00487231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist