Individual
JONATHAN F SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
4000 EDITH BLVD NE, ALBUQUERQUE, NM 87107-2222
(505) 469-2272
Mailing address
4000 EDITH BLVD NE, ALBUQUERQUE, NM 87107-2222
(505) 469-2272
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2023-0098
NM
Other
Enumeration date
06/13/2017
Last updated
06/28/2023
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