Individual
MR. JEFFREY MARSHALL SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LSW
Contact information
Practice address
2157 GREENBRIER ST, CHARLESTON, WV 25311-9623
(304) 344-5924
(304) 344-3503
Mailing address
2157 GREENBRIER STREET, CHARLESTON, WV 25311
(304) 344-5924
(304) 344-3503
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00940900
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP00940900
WV SOCIAL WORK LICENSE
WV
Enumeration date
04/23/2007
Last updated
07/08/2007
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