Organization
SPARKLE HEALING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER MABRY LCPC (CEO/CLINICAL DIRECTOR)
(240) 685-1940
Entity
Organization
Contact information
Practice address
4328 FARRAGUT ST, HYATTSVILLE, MD 20781-2032
(240) 685-1940
Mailing address
4328 FARRAGUT ST, HYATTSVILLE, MD 20781-2032
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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