Provider Demographics
NPI:1891287983
Name:SPRAGUE, ADRIENNE WHITAKER (SLP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:WHITAKER
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:WHITAKER
Other - Last Name:DOUGHTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:749 9TH ST UNIT 254
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1065
Mailing Address - Country:US
Mailing Address - Phone:602-696-3006
Mailing Address - Fax:
Practice Address - Street 1:17100 E SHEA BLVD STE 600
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6663
Practice Address - Country:US
Practice Address - Phone:918-381-9048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist