Provider Demographics
NPI:1932710266
Name:SPRADLIN, FAUNIA ANN
Entity Type:Individual
Prefix:
First Name:FAUNIA
Middle Name:ANN
Last Name:SPRADLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FAUNIA
Other - Middle Name:ANN
Other - Last Name:SZCZPANSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO PIKE STE 702
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-2679
Mailing Address - Country:US
Mailing Address - Phone:844-359-7629
Mailing Address - Fax:615-577-5654
Practice Address - Street 1:613 STEPHENSON AVE STE 206
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5841
Practice Address - Country:US
Practice Address - Phone:912-349-2479
Practice Address - Fax:615-577-5654
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INRBT-19-87210106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician