Provider Demographics
NPI:1023759743
Name:SPRUILL, BRETT LEE II
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:LEE
Last Name:SPRUILL
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11507 BIRCH FOREST CIR W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-3385
Mailing Address - Country:US
Mailing Address - Phone:904-832-5847
Mailing Address - Fax:
Practice Address - Street 1:1904 FARRAGUT PL
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3420
Practice Address - Country:US
Practice Address - Phone:904-401-9320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst