Provider Demographics
NPI:1053396671
Name:SPENCER, ANNE COTTRELL (MS, CGC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:COTTRELL
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 OLD PENITENTIARY RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-8249
Mailing Address - Country:US
Mailing Address - Phone:208-334-2235
Mailing Address - Fax:208-334-2382
Practice Address - Street 1:2220 OLD PENITENTIARY RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83712-8249
Practice Address - Country:US
Practice Address - Phone:208-334-2235
Practice Address - Fax:208-334-2382
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS