Healthcare Provider Details

I. General information

NPI: 1184885220
Provider Name (Legal Business Name): SPRITS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9953 MADISON WALK AVE
LAS VEGAS NV
89149-3770
US

IV. Provider business mailing address

9953 MADISON WALK AVE
LAS VEGAS NV
89149-3770
US

V. Phone/Fax

Practice location:
  • Phone: 702-445-3107
  • Fax:
Mailing address:
  • Phone: 702-445-3107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License NumberSP-942
License Number StateNV

VIII. Authorized Official

Name: HEATHER L BUEHLER
Title or Position: OWNER/PRESIDENT
Credential: M.S., CCC-SLP
Phone: 702-445-3107