Individual
TIMOTHY SPROWL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
774 AUTUMN RIDGE DR, WESTLAND, MI 48185-9648
(734) 812-5878
Mailing address
16213 MANSFIELD ST, DETROIT, MI 48235-3630
(734) 812-5878
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6361006066
MI
Other
Enumeration date
12/05/2014
Last updated
10/28/2020
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