Healthcare Provider Details

I. General information

NPI: 1427866581
Provider Name (Legal Business Name): SPROUTSTERS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2024
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

643 MARMOT LN
GRANTHAM NH
03753
US

IV. Provider business mailing address

PO BOX 1454
GRANTHAM NH
03753-1454
US

V. Phone/Fax

Practice location:
  • Phone: 860-776-6263
  • Fax:
Mailing address:
  • Phone: 347-578-1008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA BAEZA STORBERG
Title or Position: CHIEF CLINICAL OFFICER
Credential: MA, MS, BCBA
Phone: 860-776-6263