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1386499184
JESSE RYAN SPROUSE
KETTERING, OH
NPI
1386499184
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2024-04-23
Last Update Date
2024-04-23
Business Address
MR. JESSE RYAN SPROUSE
1324 WILLOWDALE AVE
KETTERING, OH 45429-5148
Phone number: 937-361-9391
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Mailing Address
MR. JESSE RYAN SPROUSE
1324 WILLOWDALE AVE
KETTERING, OH 45429-5148
Phone number: 937-361-9391
Copy
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