Individual
STEPHANIE SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0120
Mailing address
36 CENTRAL AVE, WELLSBORO, PA 16901
(570) 723-0120
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP005827
PA
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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