Provider Information for 1023666252
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DAVID SPROUSE LMHC
Sex: Male
NPI: 1023666252
Last Updated: 2019-08-30
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1023666252 | ||||||||
| Enumeration Date | 2019-08-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1130 N NIMITZ HWY RM C302 HONOLULU, HI 96817-6501 United States Phone: 434-832-9001 | Fax: | ||||||||
| Primary Practice Address | 1130 N NIMITZ HWY RM C302 HONOLULU, HI 96817-6501 United States Phone: 808-566-8201 | Fax:808-538-0474 | ||||||||
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