Healthcare Provider Details

I. General information

NPI: 1316736325
Provider Name (Legal Business Name): SKILLFUL SPROUTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

264 MATFIELD ST
WEST BRIDGEWATER MA
02379-1314
US

IV. Provider business mailing address

264 MATFIELD ST
WEST BRIDGEWATER MA
02379-1314
US

V. Phone/Fax

Practice location:
  • Phone: 508-245-4703
  • Fax:
Mailing address:
  • Phone: 508-245-4703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XF0002X
TaxonomyFeeding, Eating & Swallowing Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MADISON WELCH
Title or Position: MANAGING MEMBER
Credential: MS, OT, OTR/L
Phone: 508-245-4703