Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 225XM0800X | Mental Health | 26343 | MD |
NPI | 1891212338 |
---|---|
Provider Name | Joshua Spruill |
First Address | Gainesville, FL 32608-4006 |
Second Address | Waldorf, MD 20601-2806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2017 |
Last Update Date | 03/06/2021 |