Provider Demographics
NPI:1740049642
Name:SPROUT AND THRIVE LLC
Entity type:Organization
Organization Name:SPROUT AND THRIVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BREEANA
Authorized Official - Middle Name:E
Authorized Official - Last Name:MILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR/L, C/NDT
Authorized Official - Phone:206-730-3236
Mailing Address - Street 1:23222 E ECHO LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-6813
Mailing Address - Country:US
Mailing Address - Phone:206-730-3236
Mailing Address - Fax:
Practice Address - Street 1:23222 E ECHO LAKE RD
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-6813
Practice Address - Country:US
Practice Address - Phone:206-730-3236
Practice Address - Fax:206-735-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty