Provider Demographics
NPI:1760221212
Name:SPOOR, SANDRA EMMA (LICSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:EMMA
Last Name:SPOOR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ROCKLAND ST APT 1
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02748-3208
Mailing Address - Country:US
Mailing Address - Phone:774-438-4734
Mailing Address - Fax:
Practice Address - Street 1:91 ROCKLAND ST APT 1
Practice Address - Street 2:
Practice Address - City:DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02748-3208
Practice Address - Country:US
Practice Address - Phone:774-438-4734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-23
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1142521104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker