Individual
DEANNA SPROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
49 OLIVE ST, GALLIPOLIS, OH 45631-1632
(740) 441-5809
(740) 578-9242
Mailing address
49 OLIVE ST, GALLIPOLIS, OH 45631-1632
(740) 441-5809
(740) 578-9242
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
843113347
—
OH
Enumeration date
01/24/2023
Last updated
03/23/2023
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