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Individual

KRISTEN LANE SPROUT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
2417 SILVERSIDE RD, WILMINGTON, DE 19810-4531
(302) 521-6330
Mailing address
105 CHRISTINA LANDING DR, UNIT 1101, WILMINGTON, DE 19801-5200

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
B1-0000863
DE
103TC0700X
Clinical Psychologist
PS016339
PA

Other

Enumeration date
01/17/2011
Last updated
01/17/2011
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