DERRICK SPROUSE

SANTA MONICA, CA
NPI1336683895
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  C033040315)
Enumeration Date2016-12-16
Last Update Date2016-12-16
Business Address
-- DERRICK SPROUSE
905 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
Mailing Address
-- DERRICK SPROUSE
905 PICO BLVD
SANTA MONICA, CA 90405-1326
Phone number: 310-314-6200
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