Healthcare Provider Details

I. General information

NPI: 1730002247
Provider Name (Legal Business Name): LYDIA SPRENG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 PUBLIC SQ STE 330
TROY OH
45373-5200
US

IV. Provider business mailing address

405 PUBLIC SQ STE 330
TROY OH
45373-5200
US

V. Phone/Fax

Practice location:
  • Phone: 937-998-4714
  • Fax:
Mailing address:
  • Phone: 937-998-4714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberC.2607880-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: