Organization
SPROUT HEALTHY HABITS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE ANN LEROY RD (OWNER-OPERATOR)
(248) 821-9388
Entity
Organization
Contact information
Practice address
984 SPRINGFIELD CT, NORTHVILLE, MI 48167-1030
(248) 821-9388
Mailing address
984 SPRINGFIELD CT, NORTHVILLE, MI 48167-1030
(248) 821-9388
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
727212
MI
Other
Enumeration date
08/05/2016
Last updated
08/05/2016
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