Provider Demographics
NPI:1073259719
Name:SPRATLEY, SAAVON
Entity Type:Individual
Prefix:MR
First Name:SAAVON
Middle Name:
Last Name:SPRATLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19016 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-6118
Mailing Address - Country:US
Mailing Address - Phone:757-256-4987
Mailing Address - Fax:
Practice Address - Street 1:19016 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-6118
Practice Address - Country:US
Practice Address - Phone:757-256-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst