MEDICARE: AUDRIE SPROUSE OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0119011313	VA

General Provider Information

NPI Number	:	1144176470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUDRIE SPROUSE OT

Provider Business Mailing Address
First Line	:	7 CARNEGIE PLZ
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-1000
Country	:	US
Telephone Number	:	877-407-3422
Fax Number	:	877-407-4329

Provider Business Practice Location Address
First Line	:	111 DENNY LN
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22603-4832
Country	:	US
Telephone Number	:	877-407-3422
Fax Number	:	877-407-4329

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ AUDRIE SPROUSE OT” Practice Location

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