Individual
LANA JEAN SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1401 CHESTER BLVD, RICHMOND, IN 47374-1908
(765) 983-3000
(765) 983-3210
Mailing address
607 SOUTH ST, FOUNTAIN CITY, IN 47341-9446
(765) 847-5415
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004670A
IN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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