Organization
SPROUTED BEAN PEDIATRICS AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SABRINA MICHELLE FOULKS-THOMAS RN, CPM, LM, IBCLC (OWNER)
(612) 237-2746
Entity
Organization
Contact information
Practice address
N63W23675 MAIN ST, SUSSEX, WI 53089-3977
(612) 237-2746
Mailing address
W233N7735 CHESTNUT CT, SUSSEX, WI 53089-1522
(612) 237-2746
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/03/2025
Last updated
05/03/2025
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