Individual
DESTYNY SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 486-9034
Mailing address
5808 HACKBERRY LN, BRASELTON, GA 30517-5114
(850) 631-6298
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
GA
Other
Enumeration date
09/25/2023
Last updated
09/25/2023
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