| Sprout Grow Blossom Llc | |
|
19 Downstream Dr Flanders NJ 07836-9568 | |
| (973) 634-7772 | |
| Not Available |
| Full Name | Sprout Grow Blossom Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19 Downstream Dr, Flanders, New Jersey |
| Authorized Official Name and Position | Stephanie Fredericka (OWNER/CLINICIAN) |
| Authorized Official Contact | 9736347772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprout Grow Blossom Llc 19 Downstream Dr Flanders NJ 07836-9568 Ph: (973) 634-7772 | Sprout Grow Blossom Llc 19 Downstream Dr Flanders NJ 07836-9568 Ph: (973) 634-7772 |
| NPI Number | 1336739176 |
|---|---|
| Provider Enumeration Date | 01/26/2021 |
| Last Update Date | 01/26/2021 |
| Certification Date | 01/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336739176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
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