| Skill Sprout, Llc | |
|
128 Washington Square Washington IL 61571 | |
| (800) 773-1682 | |
| (800) 773-1682 |
| Full Name | Skill Sprout, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 128 Washington Square, Washington, Illinois |
| Authorized Official Name and Position | Amy Shymansky (OWNER / OPERATOR) |
| Authorized Official Contact | 8007731682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Skill Sprout, Llc 128 Washington Square Washington IL 61571 Ph: (800) 773-1682 | Skill Sprout, Llc 128 Washington Square Washington IL 61571 Ph: (800) 773-1682 |
| NPI Number | 1659600948 |
|---|---|
| Provider Enumeration Date | 12/15/2009 |
| Last Update Date | 07/24/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659600948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | 1084887 (Maryland) | Primary |
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