MEDICARE: KAITLIN BROOKE SPRAGUE

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	106S00000X	Behavior Technician	RBT-25-43967	TX

General Provider Information

NPI Number	:	1528949823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN BROOKE SPRAGUE

Provider Business Mailing Address
First Line	:	26910 MOSSY LEAF LN
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77433-1636
Country	:	US
Telephone Number	:	512-618-3116
Fax Number	:

Provider Business Practice Location Address
First Line	:	25201 KUYKENDAHL RD
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-3351
Country	:	US
Telephone Number	:	281-894-1423
Fax Number	:

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

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	09/11/2025

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Directions to “ KAITLIN BROOKE SPRAGUE ” Practice Location

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