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Individual

BAXTER SPROUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
851 SE PIONEER WAY STE 201, OAK HARBOR, WA 98277-5789
(360) 333-5684
Mailing address
PO BOX 708, MOUNT VERNON, WA 98273-0708
(360) 708-1308

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
106S00000X
Behavior Technician

Other

Enumeration date
09/26/2022
Last updated
09/26/2022
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