Provider Demographics
NPI:1306411459
Name:SPRUNG, JOSHUA GERALD
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:GERALD
Last Name:SPRUNG
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 1:9064 BOCA GARDENS PKWY APT A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-1767
Mailing Address - Country:US
Mailing Address - Phone:561-703-6728
Mailing Address - Fax:
Practice Address - Street 1:3153 CANADA CT
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-5517
Practice Address - Country:US
Practice Address - Phone:561-703-6728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical