Provider Demographics
NPI:1770234262
Name:SPROUT AND LEARN, LLC
Entity Type:Organization
Organization Name:SPROUT AND LEARN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:P
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:502-744-9284
Mailing Address - Street 1:7013 BIRNAMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258-3852
Mailing Address - Country:US
Mailing Address - Phone:502-744-9284
Mailing Address - Fax:
Practice Address - Street 1:7013 BIRNAMWOOD DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-3852
Practice Address - Country:US
Practice Address - Phone:502-744-9284
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty