Spencer Shotley, LADC, CADC III

NPI 1740560804 · on the registry since 2011 · sole proprietor

Practice

Address: 115 6th Street Nw
Cass Lake, MN 56633
Phone: (218) 760-9257
Organisation at this address: Leech Lake Tribal Council
Leech Lake Tribal Council
Leech Lake Band Of Ojibwe
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 9

Registry record

Primary taxonomy: 101YA0400X
101YA0400X
Licence states on file: MN
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-08-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota